Individual
MARK H TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12901 BRUCE B DOWNS BLVD, TAMPA, FL 33612-4742
(813) 974-1366
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ME 99904
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06353
BLUE CROSS BLUE SHIELD
FL
05
—
279534500
—
FL
Enumeration date
08/14/2006
Last updated
03/31/2021
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