Individual
DR. DAVID VAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3001 W DR MARTIN LUTHER KING JR BLVD FL 3, TAMPA, FL 33607-6307
(813) 870-4933
(813) 870-4887
Mailing address
3001 W DR MLK BLVD, TAMPA, FL 33607-6307
(813) 870-4933
(813) 870-4887
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OS15869
FL
208D00000X
General Practice Physician
UO5181
FL
208M00000X
Hospitalist Physician
Primary
OS15869
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102922200
—
FL
Enumeration date
05/24/2016
Last updated
03/28/2022
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