MEDICARE: DR. RAUL E. TAMAYO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME0050911	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ME0050911	OTHER	FL	MEDICAL LICENSE
2	04355	OTHER	FL	BLUE CROSS PROVIDER #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1568437689
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAUL E. TAMAYO M.D.

Provider Business Mailing Address
First Line	:	1325 S INTERNATIONAL PKWY
Second Line	:	SUITE 2241
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1695
Country	:	US
Telephone Number	:	407-636-9663
Fax Number	:	407-636-9664

Provider Business Practice Location Address
First Line	:	1325 S INTERNATIONAL PKWY
Second Line	:	SUITE 2241
City	:	LAKE MARY
State	:	FL
Zip	:	32746-1695
Country	:	US
Telephone Number	:	407-636-9663
Fax Number	:	407-636-9664

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/22/2006
Last Update Date	:	10/28/2015

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Directions to “ DR. RAUL E. TAMAYO M.D.” Practice Location

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