Individual
PAUL J TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 LAKELAND HILLS BLVD, LAKELAND, FL 33805-3019
(863) 680-7000
(863) 680-7420
Mailing address
P.O. BOX 95004, LAKELAND, FL 33804-5004
(863) 680-7000
(863) 680-7420
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35-079679
OH
207L00000X
Anesthesiology Physician
Primary
ME101013
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000285200
—
FL
Enumeration date
03/19/2008
Last updated
04/28/2010
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