Individual
JEAN TAN GO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
12902 USF MAGNOLIA DR, TAMPA, FL 33612-9416
(813) 745-7365
(813) 449-8618
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
(813) 745-7365
(813) 449-8618
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
ME105339
FL
207R00000X
Internal Medicine Physician
ME105399
FL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
ME105399
FL
207RP1001X
Pulmonary Disease Physician
105399
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011905900
—
FL
Enumeration date
09/11/2007
Last updated
08/07/2024
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