Individual
AARON TAN REALISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2080 CHILD ST, JACKSONVILLE, FL 32214-2514
(904) 542-7300
Mailing address
8325 CHASON RD E, JACKSONVILLE, FL 32244-5445
(251) 786-3875
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT23056
FL
Other
Enumeration date
08/20/2020
Last updated
06/04/2025
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