Provider Demographics
NPI:1285616599
Name:ZHANG, TAO (MD, PHD)
Entity type:Individual
Prefix:
First Name:TAO
Middle Name:
Last Name:ZHANG
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 BUTLER ST
Mailing Address - Street 2:PALM BEACH PATHOLOGY PA
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33407-6006
Mailing Address - Country:US
Mailing Address - Phone:561-659-0770
Mailing Address - Fax:561-802-3504
Practice Address - Street 1:2013 PONCE DE LEON AVE
Practice Address - Street 2:PAL BEACH PATHOLOGY PA
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-6019
Practice Address - Country:US
Practice Address - Phone:561-659-0770
Practice Address - Fax:561-802-3504
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME80603207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL35643OtherBLUE CROSS BLUE SHIELD
FL259397100Medicaid
FL35643OtherBLUE CROSS BLUE SHIELD
FL35643ZMedicare PIN
FL259397100Medicaid
H34194Medicare UPIN
FL35643YMedicare PIN