Individual
LUCIANA TANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
13610 BRUCE B DOWNS BLVD, TAMPA, FL 33613-4650
(813) 977-2777
Mailing address
5100 BURCHETTE RD, UNIT 705, TAMPA, FL 33647-1504
(954) 804-1140
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA9104829
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001182400
—
FL
Enumeration date
04/22/2009
Last updated
11/21/2012
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