Provider Demographics
NPI:1942181953
Name:TARACENA, WILLIAM ARMANDO
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ARMANDO
Last Name:TARACENA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 AVONDALE LN
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-2027
Mailing Address - Country:US
Mailing Address - Phone:757-298-9583
Mailing Address - Fax:
Practice Address - Street 1:1031 LOFTIS BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-2981
Practice Address - Country:US
Practice Address - Phone:757-736-9525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3913752471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography