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General NPI Number Information
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NPI Number | 1649707621
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Entity Type | Individual
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Provider Name | TATIANA ZANGANEH MD
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Gender | Female
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Dates
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Enumeration Date | 05/22/2017
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 11390 SUMMERLIN SQUARE DR
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City | FORT MYERS BEACH
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State | FL
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Zip | 33931-5300
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Country | US
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Telephone | 239-343-8880
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Fax | 239-343-4213
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Provider Business Mailing Address
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Address Line | PO BOX 2147
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City | FORT MYERS
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State | FL
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Zip | 33902-2147
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Country | US
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Telephone | 239-343-8880
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Fax | 239-343-4213
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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 | 207WX0110X
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Taxonomy Name | Pediatric Ophthalmology and Strabismus Specialist Physician Physician
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License Number | MD473186
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207WX0110X
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Taxonomy Name | Pediatric Ophthalmology and Strabismus Specialist Physician Physician
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License Number | 0101265404
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License Number State | VA
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 0101265404
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License Number State | VA
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Taxonomy #4
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | ME163313
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License Number State | FL
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