JOHN K HAN MD PA
Osteopathic Medicine in Ruskin, FL

License number
Florida 80470
Category
Osteopathic Medicine
Type
Infectious Disease
Owner
Name: JOHN K HAN MD
Title: MD/ OWNER
Phone: (813) 230-4010
Address
Address 2
4020 State Road 674 STE 2, Ruskin, FL 33573
PO Box 2741, Riverview, FL 33568
National Provider ID: 1841506383
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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JOHN K. HAN MD P.A

Riverview, FL  -  Ruskin, FL

Status:
Inactive
Industry:
Medical Doctor's Office
Doing business as:
John K Han MD PA
Inactive reason:
NAME CHANGE AMENDMENT
Registration:
Jul 10, 2002
Inactive since:
Mar 12, 2003
Addresses:
13140 Elk Mtn Dr SUITE B, Riverview, FL 33579 (Physical)
Riverview, FL 33568 (Mailing)
4020 Sun City Ctr Blvd, Ruskin, FL 33573
State ID:
P02000075483
Business type:
Florida Profit Corporation
Manager, Office Managers:
John Han (Medical Doctor), 14724 Heronglen Dr, Lithia, FL 33547 (Physical),Stacey Robinson Manager, Office Manager, inactive
Agent:
Han, John,14724 Heronglen Dr, Lithia, FL 33547 (Physical)
EIN:
113647002

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