Individual
GUY TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409
(352) 596-6632
(352) 688-7224
Mailing address
11375 CORTEZ BLVD, BROOKSVILLE, FL 34613-5409
(352) 596-6632
(352) 688-7224
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME88006
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
269788200
—
FL
Enumeration date
12/08/2006
Last updated
09/19/2012
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