Provider Demographics
NPI:1205928512
Name:ANGEL E TAFUR MD PA
Entity type:Organization
Organization Name:ANGEL E TAFUR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAFUR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:352-350-6241
Mailing Address - Street 1:1503 BUENOS AIRES BLVD
Mailing Address - Street 2:BUILDING 160
Mailing Address - City:THE VILLAGES
Mailing Address - State:FL
Mailing Address - Zip Code:32159-6821
Mailing Address - Country:US
Mailing Address - Phone:352-350-6241
Mailing Address - Fax:352-350-6241
Practice Address - Street 1:1503 BUENOS AIRES BLVD
Practice Address - Street 2:BUILDING 160
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32159-6821
Practice Address - Country:US
Practice Address - Phone:352-350-6241
Practice Address - Fax:352-350-6241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2011-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0073896207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK8849Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER