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Individual

BEN HENRY NILLES BAANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
13601 BRUCE B DOWNS BLVD BLDG SUITE160, TAMPA, FL 33613-4657
(863) 971-6000
Mailing address
3100 E FLETCHER AVE, TAMPA, FL 33613-4613
(863) 971-6000

Taxonomy

Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
TRN39963
FL

Other

Enumeration date
05/30/2024
Last updated
05/30/2024
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