Provider Demographics
NPI:1407047277
Name:AVENTURA, EMILY TAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:TAN
Last Name:AVENTURA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMILY
Other - Middle Name:AQUILINO
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD,
Mailing Address - Street 1:2020 GRAVIER ST
Mailing Address - Street 2:7TH FLOOR, SUITE D
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2272
Mailing Address - Country:US
Mailing Address - Phone:504-423-3689
Mailing Address - Fax:
Practice Address - Street 1:433 BOLIVAR ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2256
Practice Address - Country:US
Practice Address - Phone:504-423-3689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY53562207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine