Organization
EKIONG C. TAN M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EKIENG CHUA TAN M.D. (PRESIDENT)
(941) 425-5405
Entity
Organization
Contact information
Practice address
779 MEDICAL DR, SUITE #5, ENGLEWOOD, FL 34223-3980
(941) 425-5405
(941) 475-7689
Mailing address
779 MEDICAL DR, SUITE #5, ENGLEWOOD, FL 34223-3980
(941) 425-5405
(941) 475-7689
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME 0045958
FL
Other
Enumeration date
07/17/2006
Last updated
10/05/2007
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