Individual
EDISON N TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1840 N HIGHLAND AVE, CLEARWATER, FL 33755-2138
(727) 442-3001
(727) 467-9106
Mailing address
1840 N HIGHLAND AVE, CLEARWATER, FL 33755-2138
(727) 442-3001
(727) 467-9106
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
ME78501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49390
BLUE CROSS
—
Enumeration date
02/13/2006
Last updated
02/04/2008
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