Ekiong C. Tan M.D., P.a.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

ME 0045958 Issued in FL

Legal business name

EKIONG C. TAN M.D., P.A.

Practice address

779 Medical Dr
Suite #5
Englewood, FL 34223-3980

Phone

(941) 425-5405

Fax

(941) 475-7689

NPI assigned

Jul 17, 2006

Organization subpart

No

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

Authorized official

Name

Ekieng Chua Tan, M.D.

Title

President

Phone

(941) 425-5405

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1528085388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "779 MEDICAL DR",
            "address_2": "SUITE #5",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233980",
            "telephone_number": "941-425-5405",
            "fax_number": "941-475-7689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "779 MEDICAL DR",
            "address_2": "SUITE #5",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233980",
            "telephone_number": "941-425-5405",
            "fax_number": "941-475-7689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EKIONG C. TAN M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-17",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "TAN",
        "authorized_official_first_name": "EKIENG",
        "authorized_official_middle_name": "CHUA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "941-425-5405",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Urology",
            "state": "FL",
            "license": "ME 0045958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan M Earles, MSW, LCSW
• Carolyn Edlund, PA
• Edward Fetherolf M D P a
• Ehra Medical Services of Florida LLC
• Andrew Cole Eisenberg, MD
• Elite Cardiology Care, LLC
• Elizabeth Cupo
• Ellington Eyecare PLLC
• Charles E Ellis
• Emeritus Properties V, Inc.

• Urology Physician in Englewood, FL
• Providers in Englewood, FL by specialty
• Urology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.