MEDICARE: MICHAEL JUDE TARANTINO MD

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	208600000X	Surgery Physician	010736	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750382784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL JUDE TARANTINO MD

Provider Business Mailing Address
First Line	:	108 ARBOR LN
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70563-2822
Country	:	US
Telephone Number	:	337-365-5881
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 ARBOR LN
Second Line	:
City	:	NEW IBERIA
State	:	LA
Zip	:	70563-2822
Country	:	US
Telephone Number	:	337-365-5881
Fax Number	:

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

Provider Enumeration Date	:	08/01/2005
Last Update Date	:	12/09/2008

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