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Individual

SCOTT DAVID TANNENBAUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4399 NOB HILL ROAD, SUNRISE, FL 33351
(954) 746-1338
(954) 746-1331
Mailing address
PO BOX 267515, WESTON, FL 33326
(954) 746-1338
(954) 746-1331

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
ME57381
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
ME57301
STATE LICENSE
FL
Enumeration date
08/14/2006
Last updated
07/08/2007
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