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General NPI Number Information
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NPI Number | 1831652619
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Entity Type | Individual
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Provider Name | MICHAEL TANG DPT
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Gender | Male
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Dates
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Enumeration Date | 04/09/2019
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Last Update Date | 04/09/2019
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Provider Practice Location Address
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Address Line | 5597 N DIXIE HWY
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City | OAKLAND PARK
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State | FL
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Zip | 33334-3406
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Country | US
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Telephone | 954-736-7953
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Fax |
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Provider Business Mailing Address
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Address Line | 3932 HERON RIDGE LN
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City | WESTON
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State | FL
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Zip | 33331-3718
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Country | US
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Telephone | 954-736-7953
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 32309
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License Number State | FL
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