Individual
TAE H SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3501 JOHNSON ST, HOLLYWOOD, FL 33021-5421
(954) 265-7750
(954) 276-0280
Mailing address
2900 CORPORATE WAY, DOOR D, MIRAMAR, FL 33025-3925
(954) 276-5603
(954) 276-0357
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
ME165335
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120907500
—
FL
Enumeration date
10/28/2008
Last updated
01/24/2025
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