Healthcare Provider Details

I. General information

NPI: 1205249596
Provider Name (Legal Business Name): IAN TAFEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 04/09/2022
Certification Date: 04/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1321 NW 14TH ST
MIAMI FL
33125-1673
US

IV. Provider business mailing address

PO BOX 100265
GAINESVILLE FL
32610-0265
US

V. Phone/Fax

Practice location:
  • Phone: 305-243-6946
  • Fax: 305-243-3337
Mailing address:
  • Phone: 352-273-9000
  • Fax: 352-392-8413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME150033
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: