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General NPI Number Information
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NPI Number | 1538746326
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Entity Type | Individual
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Provider Name | BRIAN TAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 12/23/2024
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Provider Practice Location Address
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Address Line | 2901 W SWANN AVE
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City | TAMPA
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State | FL
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Zip | 33609-4056
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Country | US
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Telephone | 813-873-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 7020 CENTRAL AVE
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City | ST PETERSBURG
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State | FL
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Zip | 33707-1213
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Country | US
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Telephone |
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | ME168748
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License Number State | FL
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