MEDICARE: DR. TAMMY HSU D.M.D.

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	122300000X	Dentist	DN17239	FL

General Provider Information

NPI Number	:	1851501712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAMMY HSU D.M.D.

Provider Business Mailing Address
First Line	:	8118 COLONIAL VILLAGE DR
Second Line	:	APT.# 102
City	:	TAMPA
State	:	FL
Zip	:	33625-3198
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3910 NORTHDALE BLVD
Second Line	:	SUITE 102
City	:	TAMPA
State	:	FL
Zip	:	33624-1800
Country	:	US
Telephone Number	:	813-969-0294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	07/08/2007

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