Luis T Tavarez Gonzalez, M.D.

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

License

18155 Issued in PR

Practice address

107 Ave Ortegon Ste 100
Guaynabo, PR 00966-2516

Phone

(787) 425-0525

Fax

(787) 425-0526

NPI assigned

Apr 7, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pda Maxillofacial Surgery LLC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Guaynabo, PR
  • NPI 1548853179
  NPD
• Servicios Medicos Universitarios Inc

  • Psychiatric Hospital Unit
  • Carolina, PR
  • NPI 1881816932

  Student in an Organized Health Care Education/Training Program

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1780974063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366255",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009366255",
            "telephone_number": "787-425-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 AVE ORTEGON STE 100",
            "city": "GUAYNABO",
            "state": "PR",
            "postal_code": "009662516",
            "telephone_number": "787-425-0525",
            "fax_number": "787-425-0526"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Calle Isla Verde",
            "address_2": "villas de la playa",
            "address_purpose": "LOCATION",
            "city": "Vega Baja",
            "state": "PR",
            "postal_code": "006936049",
            "country_code": "US",
            "telephone_number": "787-375-9026",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Carretera 3 km 8.3",
            "address_2": "Ave 65 de infanteria",
            "address_purpose": "LOCATION",
            "city": "carolina",
            "state": "PR",
            "postal_code": "00984",
            "country_code": "US",
            "telephone_number": "787-757-1800",
            "fax_number": "787-276-2205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAVAREZ GONZALEZ",
        "first_name": "LUIS",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-07",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PR",
            "license": "18155",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "18155",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PR",
            "license": "18155",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "PR",
            "license": "18155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paola Cristina Tabaro Pico, MD
• Raymond Taboas Rios, 1676P
• Sara Tacher-Roffe, PSY.D.
• Emily Yaniris Tapia Romano
• Liza Y Tapia Tapia, MD
• Obdulia Taveras
• Carminia Tello Santini, M.D
• Andre Brian Tester
• The Janz Corporation
• The Right Answer Inc

• Geriatric Medicine (Family Medicine) Physician in Guaynabo, PR
• Providers in Guaynabo, PR by specialty
• Geriatric Medicine (Family Medicine) Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.