MEDICARE: SIM YIN TAN PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1205249752
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIM YIN TAN PHD

Provider Business Mailing Address
First Line	:	2002 N LOIS AVE STE 400
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2394
Country	:	US
Telephone Number	:	813-498-6400
Fax Number	:

Provider Business Practice Location Address
First Line	:	2002 N LOIS AVE STE 400
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-2394
Country	:	US
Telephone Number	:	813-498-6400
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2014
Last Update Date	:	03/28/2021

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Directions to “ SIM YIN TAN PHD” Practice Location

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