Provider Demographics
NPI:1932272705
Name:TAGLIONE, ROBERTO (MD, DDS)
Entity Type:Individual
Prefix:
First Name:ROBERTO
Middle Name:
Last Name:TAGLIONE
Suffix:
Gender:M
Credentials:MD, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 ASHLEY OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:WESLEY CHAPEL
Mailing Address - State:FL
Mailing Address - Zip Code:33543-7019
Mailing Address - Country:US
Mailing Address - Phone:813-447-0128
Mailing Address - Fax:
Practice Address - Street 1:2118 ASHLEY OAKS CIR
Practice Address - Street 2:
Practice Address - City:WESLEY CHAPEL
Practice Address - State:FL
Practice Address - Zip Code:33543-7019
Practice Address - Country:US
Practice Address - Phone:813-907-7545
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME88676204E00000X
FLDN16453204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLU95742Medicare UPIN
FL85644Medicare ID - Type Unspecified