Physician Compare National (NPI:1104897263)

HEALTHCARE PROVIDER: JOSE E TAVERAS BROSSA MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1104897263
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1254300023
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050923000048
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TAVERAS BROSSA
	Individual professional last name
Provider First Name	JOSE
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1976
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	AVE CAMPO RICO
	Group Practice or individual's line 1 address
Line 2 Street Address	1 COUNTRY CLUB
	Group Practice or individual's line 2 address
City	CAROLINA
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	00982
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y