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Individual

THIDAPORN TANPATTANA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
92 W MILLER ST, ORLANDO, FL 32806-2032
(407) 649-9111
(954) 858-0404
Mailing address
1500 CONCORD TER, SUNRISE, FL 33323-2815
(800) 243-3839
(954) 858-0404

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
OS8936
FL
208M00000X
Hospitalist Physician
OS8936
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
268709700
FL
Enumeration date
01/23/2006
Last updated
06/22/2014
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