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General NPI Number Information
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NPI Number | 1528257458
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Entity Type | Organization
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Legal Business Name | SCOTT D TANNENBAUM MD PA
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 4399 N NOB HILL RD
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City | SUNRISE
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State | FL
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Zip | 33351-5813
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Country | US
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Telephone | 954-746-1338
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Fax | 954-746-1331
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Provider Business Mailing Address
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Address Line | PO BOX 267515
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City | WESTON
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State | FL
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Zip | 33326-7515
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Country | US
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Telephone | 954-746-1338
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Fax | 954-746-1331
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT D TANNENBAUM
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Credential | MD
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Telephone | 954-746-1338
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | ME57381
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License Number State | FL
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