Individual
JOSE TAVAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8430 ENTERPRISE CIR STE 130, LAKEWOOD RANCH, FL 34202-4111
(941) 366-3000
(941) 366-3002
Mailing address
PO BOX 863407, ORLANDO, FL 32886-3407
(941) 917-2600
(941) 917-7884
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
22828
MS
208000000X
Pediatrics Physician
Primary
ME130063
FL
Other
Enumeration date
01/22/2013
Last updated
07/21/2022
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