Individual provider Active NPI

Luis J Taveras, PS

  • Pharmacist
  • Orlando, FL
National Provider Identifier
1932514940
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS13139 Issued in FL
Practice address
715 N Ferncreek Ave
Suite C
Orlando, FL 32803-4108
Phone
(407) 440-4504
Fax
(407) 674-7935
NPI assigned
Jun 27, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS13139 FL Primary

Addresses

Primary practice location

715 N Ferncreek Ave
Suite C
Orlando, FL 32803-4108

Mailing address

715 N Ferncreek Ave
Suite C
Orlando, FL 32803-4108
Phone (407) 440-4504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS13139FLMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Medi Show Pharmacy LLC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403827200000",
    "number": "1932514940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N FERNCREEK AVE",
            "address_2": "SUITE C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034108",
            "telephone_number": "407-440-4504",
            "fax_number": "407-674-7935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 N FERNCREEK AVE",
            "address_2": "SUITE C",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328034108",
            "telephone_number": "407-440-4504",
            "fax_number": "407-674-7935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVERAS",
        "first_name": "LUIS",
        "middle_name": "J",
        "credential": "PS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS13139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.