MEDICARE: DR. ZEGUANG REN MD

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	207T00000X	Neurological Surgery Physician	ME118822	FL
2	207T00000X	Neurological Surgery Physician	DR.0067702	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	14WW1	OTHER	FL	BLUE CROSS BLUE SHIELD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770640856
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ZEGUANG REN MD

Provider Business Mailing Address
First Line	:	3000 MEDICAL PARK DR STE 340
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-467-4290
Fax Number	:	813-467-4278

Provider Business Practice Location Address
First Line	:	3000 MEDICAL PARK DR STE 340
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4681
Country	:	US
Telephone Number	:	813-467-4290
Fax Number	:	813-467-4278

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

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	04/13/2023

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Directions to “ DR. ZEGUANG REN MD” Practice Location

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