Individual
DR. MARIO ENRIQUE TANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3800 JOHNSON ST STE J, HOLLYWOOD, FL 33021-6030
(954) 967-9400
(954) 967-9551
Mailing address
5955 PONCE DE LEON BLVD., CORAL GABLES, FL 33146
(305) 661-1515
(305) 662-3723
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
ME58352
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064237100
—
FL
Enumeration date
10/04/2005
Last updated
02/08/2022
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