Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | ME94940 | FL |
Y | 208600000X | Surgeon | ME94940 | FL |
N | 2082S0105X | Plastic Hand Surgeon | ME94940 | FL |
NPI | 1437300597 |
---|---|
Provider Name | Benny Kien Hon Tan |
First Address | Jacksonville, FL 32209-6511 |
Second Address | Gilbert, AZ 85234-2165 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2008 |
Last Update Date | 26/01/2021 |