Organization
CHILDRENS CENTER FOR GASTROENTEROLOGY & NUTRITION, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIO ENRIQUE TANO MD (PRESIDENT)
(954) 967-9400
Entity
Organization
Contact information
Practice address
1150 N 35TH AVE, SUITE 545, HOLLYWOOD, FL 33021-5424
(954) 967-9400
(954) 967-9551
Mailing address
1150 N 35TH AVE, SUITE 545, HOLLYWOOD, FL 33021-5424
(954) 967-9400
(954) 967-9551
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
06/28/2010
Last updated
01/03/2011
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