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General NPI Number Information
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NPI Number | 1730105651
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Entity Type | Individual
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Provider Name | IGNATIUS ING HAN TAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 12/04/2025
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Provider Practice Location Address
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Address Line | 14713 SULLY RUN
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City | ODESSA
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State | FL
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Zip | 33556-4674
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Country | US
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Telephone | 813-475-7100
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Fax | 813-475-7119
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Provider Business Mailing Address
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Address Line | 720 BROOKER CREEK BLVD STE 215
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City | OLDSMAR
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State | FL
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Zip | 34677-2937
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Country | US
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Telephone | 813-854-2003
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Fax | 813-436-5378
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME-65867
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License Number State | FL
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