MEDICARE: L TAN MD LC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208800000X	Urology Physician	ME339964	FL

General Provider Information

NPI Number	:	1346303088
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L TAN MD LC

Provider Business Mailing Address
First Line	:	2915 MADISON ST
Second Line	:
City	:	MARIANNA
State	:	FL
Zip	:	32446-3449
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2915 MADISON ST
Second Line	:
City	:	MARIANNA
State	:	FL
Zip	:	32446-3449
Country	:	US
Telephone Number	:	850-536-2460
Fax Number	:

Authorized Official
Title or Position	:	MGR
Name	:	L TAN
Credential	:
Telephone Number	:	904-537-0954

Provider Enumeration Date	:	12/17/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1235132762 — L TAN M.D.
Practice Location Address:

2915 MADISON ST
MARIANNA, FL
32446-3449

Practice Phone: 850-526-2460
Practice Fax: 850-482-5450

1881964120 — CHRIS FOX LLC
Practice Location Address:

2915 MADISON ST
MARIANNA, FL
32446-3449

Practice Phone: 850-536-2460
Practice Fax:

1639204415 — MRS. ABBY MARIE STRICKLAND ARNP
Practice Location Address:

4636 HIGHWAY 90 STE M
MARIANNA, FL
32446-3508

Practice Phone: 850-693-7424
Practice Fax:

1508738691 — KAYLA NICOLE ROBERTS FNP-C
Practice Location Address:

6016 CROSS COUNTRY BLVD
MARIANNA, FL
32446-2511

Practice Phone: 850-693-8693
Practice Fax:

1811990005 — MRS. DEBORAH E NEWSOME ARNP-C
Practice Location Address:

4979 HEALTHY WAY
MARIANNA, FL
32446-7993

Practice Phone: 850-526-2412
Practice Fax: 850-718-0383

1073516274 — DR. JIRAYOS CHINTANADILOK M.D.
Practice Location Address:

4296 5TH AVENUE
MARIANNA, FL
32446-2173

Practice Phone: 850-482-2061
Practice Fax: 850-482-6617

Directions to “L TAN MD LC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.