Individual
MICHAEL VINCENT FLORENDO TABLANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
351 N FERDON BLVD, CRESTVIEW, FL 32536-2727
(508) 623-9798
(850) 862-0605
Mailing address
917 MAR WALT DR, FORT WALTON BEACH, FL 32547-6651
(850) 862-3979
(850) 862-0605
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
ME138845
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116653900
—
FL
Enumeration date
07/29/2007
Last updated
02/14/2024
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