Provider Demographics
NPI:1730176694
Name:HAN, HOKE TJIWAN (MD)
Entity type:Individual
Prefix:MR
First Name:HOKE
Middle Name:TJIWAN
Last Name:HAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6030 HOLLYWOOD BLVD
Mailing Address - Street 2:SUITE: 100
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33024-7964
Mailing Address - Country:US
Mailing Address - Phone:954-322-7200
Mailing Address - Fax:954-322-7203
Practice Address - Street 1:6030 HOLLYWOOD BLVD
Practice Address - Street 2:STE 100
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-7964
Practice Address - Country:US
Practice Address - Phone:954-322-7200
Practice Address - Fax:954-322-7203
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 698022085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL46455OtherBCBS
FLP954198OtherOPTIMUM
FL213743OtherWELLCARE
FLP01584474OtherRR MEDICARE
FLP1015355OtherFREEDOM
FL4785892OtherCIGNA
FLQMP000004938350OtherMOLINA
FL256075500Medicaid
FL257961OtherAVMED
FL9687OtherDIMENSION
FL7435167OtherAETNA
FL9687OtherDIMENSION
FL257961OtherAVMED
G86823Medicare UPIN