Organization
ESSENTIAL INTEGRATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TAN THANG TRAN D.C. (PRESIDENT)
(813) 253-0711
Entity
Organization
Contact information
Practice address
3715 W AZEELE ST, TAMPA, FL 33609-2807
(813) 253-0711
(813) 253-0411
Mailing address
3715 W AZEELE ST, TAMPA, FL 33609-2807
(813) 253-0711
(813) 253-0411
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
ME 84580
FL
208D00000X
General Practice Physician
Primary
OS10332
FL
208D00000X
General Practice Physician
PA 9104287
FL
Other
Enumeration date
09/28/2012
Last updated
03/12/2015
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