MEDICARE: JOSEPH TAVERNE 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	282N00000X	General Acute Care Hospital	19476	PR
2	208D00000X	General Practice Physician	ACN1118	FL

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	:	1942758339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH TAVERNE M.D.

Provider Business Mailing Address
First Line	:	111 CALLE DR LASSISSE
Second Line	:	BO PARIS ALTO
City	:	MAYAGUEZ
State	:	PR
Zip	:	00680-5434
Country	:	US
Telephone Number	:	305-726-9772
Fax Number	:

Provider Business Practice Location Address
First Line	:	5160 S JOHN YOUNG PKWY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32839-5022
Country	:	US
Telephone Number	:	844-665-4827
Fax Number	:

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

Provider Enumeration Date	:	09/14/2016
Last Update Date	:	11/06/2019

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