Provider Demographics
NPI:1083706147
Name:JOHN H. AHN. D.O.;PL
Entity Type:Organization
Organization Name:JOHN H. AHN. D.O.;PL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-796-4166
Mailing Address - Street 1:1840 MEASE DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-6602
Mailing Address - Country:US
Mailing Address - Phone:727-796-4166
Mailing Address - Fax:727-669-5849
Practice Address - Street 1:1840 MEASE DR
Practice Address - Street 2:SUITE 305
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-6602
Practice Address - Country:US
Practice Address - Phone:727-796-4166
Practice Address - Fax:727-669-5849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS0007005207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57158OtherBLUE SHIELD
FL3615915OtherAETNA
FL281931OtherAVMED
FL1598790701OtherINDIVIDUAL NPI
FLK6191Medicare ID - Type UnspecifiedGROUP
FL3615915OtherAETNA
FL281931OtherAVMED