Individual
DR. JOHN C TAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
630 RANDY LN, FORT MYERS BEACH, FL 33931-4018
(239) 463-2723
Mailing address
630 RANDY LN, FORT MYERS BEACH, FL 33931-4018
(239) 463-2723
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036049707
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036049709
—
IL
Enumeration date
06/08/2010
Last updated
04/16/2011
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