Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | ME79317 | FL |
N | 111NI0900X | Internist | ME79317 | FL |
N | 207RG0300X | Geriatric Medicine | ME79317 | FL |
NPI | 1063459436 |
---|---|
Provider Name | Dr. Tatjana Bulat |
First Address | Tampa, FL 33647-1322 |
Second Address | Tampa, FL 33612-5738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2006 |
Last Update Date | 08/07/2007 |