Provider Demographics
NPI:1215451075
Name:TAPPAN, DAVID CHRISTOPHER (LMT)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:CHRISTOPHER
Last Name:TAPPAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9229 LAKE LOTTA CIR
Mailing Address - Street 2:
Mailing Address - City:GOTHA
Mailing Address - State:FL
Mailing Address - Zip Code:34734-5009
Mailing Address - Country:US
Mailing Address - Phone:407-415-9238
Mailing Address - Fax:
Practice Address - Street 1:1603 S HIAWASSEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-6438
Practice Address - Country:US
Practice Address - Phone:407-532-6815
Practice Address - Fax:407-532-6701
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2017-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA19067208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation