Individual
NATHAN TANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 DR ML KING JR ST N, ST PETERSBURG, FL 33701-2717
(727) 825-0111
(727) 825-0011
Mailing address
333 DR MARTIN LUTHER KING JR ST N, SAINT PETERSBURG, FL 33701-2717
(727) 825-0111
(727) 825-0011
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
ME78703
FL
208000000X
Pediatrics Physician
ME78703
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
258322400
—
FL
01
—
49938
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/10/2006
Last updated
06/24/2023
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