Provider Demographics
NPI:1740508449
Name:LIU, JINLI (MD)
Entity type:Individual
Prefix:
First Name:JINLI
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JINLI
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4016 SUN CITY CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:SUN CITY CENTER
Mailing Address - State:FL
Mailing Address - Zip Code:33573-5256
Mailing Address - Country:US
Mailing Address - Phone:813-634-0119
Mailing Address - Fax:
Practice Address - Street 1:4016 SUN CITY CENTER BLVD
Practice Address - Street 2:
Practice Address - City:SUN CITY CENTER
Practice Address - State:FL
Practice Address - Zip Code:33573-5256
Practice Address - Country:US
Practice Address - Phone:813-634-0119
Practice Address - Fax:813-634-0127
Is Sole Proprietor?:No
Enumeration Date:2010-05-06
Last Update Date:2017-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY261122173000000X
CT047429207ZH0000X, 207ZP0105X
FLME114593207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No173000000XOther Service ProvidersLegal Medicine
No207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
No207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory Medicine