Provider Demographics
NPI:1477882223
Name:TAVERAS PANTALEON, ANA ESTHER (MD)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:ESTHER
Last Name:TAVERAS PANTALEON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:777 37TH ST. SUITE C-107
Mailing Address - Street 2:VERO RENAL ASSOCIATES PA
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960
Mailing Address - Country:US
Mailing Address - Phone:772-562-3234
Mailing Address - Fax:772-562-3236
Practice Address - Street 1:777 37TH ST
Practice Address - Street 2:SUITE C-107
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-4873
Practice Address - Country:US
Practice Address - Phone:772-562-3234
Practice Address - Fax:772-562-3236
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2015-01-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME113119207RN0300X
CT049249208M00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program