Individual
MAXINE C TABAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1901 LEE RD, WINTER PARK, FL 32789-1834
(407) 647-7300
(407) 647-5496
Mailing address
1901 LEE RD, WINTER PARK, FL 32789-1834
(407) 647-7300
(407) 647-5496
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
ME 50910
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03927
BCBS
FL
01
—
ME 50910
MEDICAL LICENSE
FL
Enumeration date
08/11/2005
Last updated
03/07/2023
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