Active NPI
Minh-Tam T Le
- Physician Assistant
- Palm Coast, FL
National Provider Identifier
1558972091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-10282
- Practice address
- 54 Woodlawn Dr
Palm Coast, FL 32164-7914 - Phone
- (386) 793-6938
- NPI assigned
- Aug 10, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PAX000017231 | FL | |
| Physician Assistant | 363A00000X | 0010-10282 | NC | Primary |
Addresses
Primary practice location
54 Woodlawn Dr
Palm Coast, FL 32164-7914
Mailing address
54 Woodlawn Dr
Palm Coast, FL 32164-7914
Phone (386) 793-6938
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PAX000017231 | FL | MD | Physician Assistant |
| 0010-10282 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597017600000",
"number": "1558972091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "54 WOODLAWN DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321647914",
"telephone_number": "386-793-6938"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "54 WOODLAWN DR",
"city": "PALM COAST",
"state": "FL",
"postal_code": "321647914",
"telephone_number": "386-793-6938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "MINH-TAM",
"middle_name": "T",
"name_prefix": "Miss",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-10",
"last_updated": "2020-08-10",
"certification_date": "2020-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PAX000017231",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-10282",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Coast, FL
- Shariq Latif, M.D.
- Brooke Alexis Laughlin
- Blair Ashley Lawton, APRN
- Kymber Lawver, OTR/L
- Gina Layague, P.T.
- Learned Enterprises LLC Dba Yourchiro (YourChiro Palm Coast)
- Leavitt Medical Associates of Florida Inc (Advanced Dermatology and Cosmetic Surgery)
- Nanci Marie Lechler, OCCOPATIONAL THERAPY
- Alexandra Lee
- Caitlin Lee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.