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General NPI Number Information
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NPI Number | 1871504746
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Entity Type | Individual
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Provider Name | NATHAN TANG MD
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Gender | Male
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 06/24/2023
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Provider Practice Location Address
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Address Line | 333 DR ML KING JR ST N
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City | ST PETERSBURG
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State | FL
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Zip | 33701-2717
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Country | US
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Telephone | 727-825-0111
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Fax | 727-825-0011
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Provider Business Mailing Address
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Address Line | 333 DR MARTIN LUTHER KING JR ST N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33701-2717
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Country | US
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Telephone | 727-825-0111
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Fax | 727-825-0011
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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 | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | ME78703
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME78703
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License Number State | FL
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