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Individual

MARY TANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
200 AVENUE F NE, UFJP EMERGENCY DEPARTMENT, WINTER HAVEN, FL 33881-4131
(863) 293-1861
Mailing address
PO BOX 44008, UFJP PROVIDER ENROLLMENT, JACKSONVILLE, FL 32231-4008

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
ME101952
FL

Other

Enumeration date
01/16/2007
Last updated
06/08/2010
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