Provider Demographics
NPI:1144258427
Name:TAVAREZ CARVAJAL, MARIA M (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:M
Last Name:TAVAREZ CARVAJAL
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:URBANIZACION SANJUANERA
Mailing Address - Street 2:94 VIA MORENILLA ,HSJ
Mailing Address - City:CAGUAS
Mailing Address - State:PR
Mailing Address - Zip Code:00727
Mailing Address - Country:US
Mailing Address - Phone:787-647-6926
Mailing Address - Fax:787-744-8370
Practice Address - Street 1:T1-11 CALLE 28
Practice Address - Street 2:TURABO GARDENS
Practice Address - City:CAGUAS
Practice Address - State:PR
Practice Address - Zip Code:00725
Practice Address - Country:US
Practice Address - Phone:787-286-1920
Practice Address - Fax:787-744-8370
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2017-03-21
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Provider Licenses
StateLicense IDTaxonomies
PR11457207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PRPE4141OtherPALIC PROVIDER
PR200331OtherPREFERRED HEALTH
PR89925OtherTRIPLE S
PR3489OtherPREFERRED MEDICARE CHOICE
PR7250063OtherHUMANA HEALTH PLAN
PR100057OtherCRUZ AZUL DE PR
PR400185OtherMEDICARE Y MUCHO MAS
PR7250063OtherHUMANA INSURANCE
PR7491OtherFIRST MEDICAL
PR11511457OtherGLOBAL HEALTH
PR7250063OtherHUMANA INSURANCE
PRG86402Medicare UPIN