Individual
DR. LUIS M TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10217 125TH STREET CT E, PUYALLUP, WA 98374-2761
(253) 864-4550
Mailing address
3250 ZEMKE AVE, TAMPA, FL 33621-5023
(813) 334-5782
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
15060
PR
207Q00000X
Family Medicine Physician
2010028388
MO
207Q00000X
Family Medicine Physician
Primary
MD60994726
WA
2081P0004X
Spinal Cord Injury Medicine Physician
15060
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447298278
—
MO
01
—
4281
VA PHARMACY
FL
Enumeration date
06/03/2006
Last updated
04/08/2024
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