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General NPI Number Information
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NPI Number | 1750375671
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Entity Type | Individual
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Provider Name | JAN B TAWAKOL M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 3004 ORANGE GROVE SUITE 2
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-4288
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Country | US
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Telephone | 340-715-7720
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Fax | 340-713-9002
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Provider Business Mailing Address
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Address Line | 3004 ORANGE GROVE SUITE 2
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City | CHRISTIANSTED
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State | VI
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Zip | 00820-4288
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Country | US
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Telephone | 340-715-7720
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Fax | 340-713-9002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | ME86769
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 1675
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License Number State | VI
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Taxonomy #3
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 1675
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License Number State | VI
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