Provider Demographics
NPI:1568794923
Name:CAROLE TAUB MD PC
Entity Type:Organization
Organization Name:CAROLE TAUB MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:TAUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-757-8655
Mailing Address - Street 1:2450 KENSINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33325-5242
Mailing Address - Country:US
Mailing Address - Phone:917-757-8655
Mailing Address - Fax:
Practice Address - Street 1:1779 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33024-0929
Practice Address - Country:US
Practice Address - Phone:954-964-6281
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206304207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH08371Medicare UPIN