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General NPI Number Information
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NPI Number | 1780669853
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Entity Type | Individual
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Provider Name | RICHARD E TANNENBAUM M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/13/2005
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Last Update Date | 04/16/2008
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Provider Practice Location Address
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Address Line | 8500 SW 92ND ST SUITE 208
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City | MIAMI
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State | FL
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Zip | 33156-7379
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Country | US
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Telephone | 305-271-9811
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Fax | 305-271-9821
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Provider Business Mailing Address
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Address Line | 13320 SW 104TH CT
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City | MIAMI
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State | FL
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Zip | 33176-6081
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Country | US
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Telephone | 305-253-1404
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 23255
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License Number State | FL
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