Healthcare Provider Details

I. General information

NPI: 1538113931
Provider Name (Legal Business Name): ELIZABETH DEL PRADO TAN-CHIU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 USF MAGNOLIA DR
TAMPA FL
33612-9416
US

IV. Provider business mailing address

PO BOX 198841
ATLANTA GA
30384-8441
US

V. Phone/Fax

Practice location:
  • Phone: 866-837-4112
  • Fax:
Mailing address:
  • Phone: 813-745-7365
  • Fax: 813-449-8618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME73690
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberME73690
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: