Stephen Jay Tan, PHARM.D., BCCCP

Primary specialty

Critical Care PharmacistTaxonomy code 1835C0205X

License

PS43790 Issued in FL

Practice address

655 W 8TH St
Jacksonville, FL 32209-6511

Phone

(904) 244-4147

NPI assigned

Sep 19, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568851200000",
    "number": "1457901654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 W 8TH ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322096511",
            "telephone_number": "904-244-4147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAN",
        "first_name": "STEPHEN",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., BCCCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-19",
        "last_updated": "2019-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835C0205X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Critical Care",
            "state": "FL",
            "license": "PS43790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Tan
• Joann M Tan, DNP CRNA
• Lukas H Tan, M.D.
• Mable Tan, MD
• Maridel Nazareno Tan, ARNP
• Winston Tan, MD
• Christina Tancreto, ARNP
• Tandem Health Care of Jacksonville, Inc. (Tandem Health Care of Jacksonville)
• Gaurav Tandon, MD
• Yasmeen Tandon, MD

• Critical Care Pharmacist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Critical Care Pharmacist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.