Basic Information
| Provider Information | |||||||||
| NPI: | 1467741249 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TANG | ||||||||
| FirstName: | MICHELLE | ||||||||
| MiddleName: | Q | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8905 SW 69TH TER | ||||||||
| Address2: | |||||||||
| City: | MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331732474 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7133828560 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6200 SW 73RD ST | ||||||||
| Address2: | |||||||||
| City: | SOUTH MIAMI | ||||||||
| State: | FL | ||||||||
| PostalCode: | 331434679 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7866624000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2011 | ||||||||
| LastUpdateDate: | 11/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | D0079704 | MD | N | Allopathic & Osteopathic Physicians | Pediatrics | 207R00000X | ME141471 | FL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D0079704 | MD | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | A156818 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.