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General NPI Number Information
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NPI Number | 1124717525
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Entity Type | Individual
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Provider Name | THU TANG RN
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Gender | Female
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/02/2023
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Provider Practice Location Address
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Address Line | 2314 S SEACREST BLVD STE 102
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City | BOYNTON BEACH
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State | FL
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Zip | 33435-6788
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Country | US
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Telephone | 561-735-7766
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Fax |
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Provider Business Mailing Address
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Address Line | 4402 COHUNE PALM CT
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City | GREENACRES
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State | FL
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Zip | 33463-9329
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Country | US
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Telephone | 561-715-5772
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WR0006X
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Taxonomy Name | Registered Nurse First Assistant
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License Number | RN9407906
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License Number State | FL
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