Provider Demographics
NPI:1790843498
Name:LAM, TINA M (MD)
Entity Type:Individual
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First Name:TINA
Middle Name:M
Last Name:LAM
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Gender:F
Credentials:MD
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Mailing Address - Street 1:7003 NW 11TH PL
Mailing Address - Street 2:STE 4
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32605-3176
Mailing Address - Country:US
Mailing Address - Phone:352-331-2010
Mailing Address - Fax:352-331-2050
Practice Address - Street 1:7003 NW 11TH PL
Practice Address - Street 2:STE 4
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-3176
Practice Address - Country:US
Practice Address - Phone:352-331-2010
Practice Address - Fax:352-331-2050
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2011-03-09
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Provider Licenses
StateLicense IDTaxonomies
FLME0071145208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery