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Individual

IVAN TARLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1911 N MILLS AVE, ORLANDO, FL 32803-1432
(407) 893-8200
(407) 893-8220
Mailing address
1911 N MILLS AVE, ORLANDO, FL 32803-1432
(407) 893-8200
(407) 893-8220

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME75834
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1036804
CIGNA
FL
01
1290944
UNITED HEALTH CARE
FL
01
151706765
TRI CARE
FL
01
2083692
AETNAHMO
FL
05
26216900
FL
01
26999
BCBS
FL
01
400984
GHI
01
547
WELL CARE
FL
01
5581013
AETNA PPO/POS
FL
Enumeration date
03/31/2006
Last updated
03/05/2008
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