Maxine C Tabas, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

ME 50910 Issued in FL

Practice address

1901 Lee Rd
Winter Park, FL 32789-1834

Phone

(407) 647-7300

Fax

(407) 647-5496

NPI assigned

Aug 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1962404855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891834",
            "telephone_number": "407-647-7300",
            "fax_number": "407-647-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891834",
            "telephone_number": "407-647-7300",
            "fax_number": "407-647-5496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABAS",
        "first_name": "MAXINE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-11",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "FL",
            "license": "ME 50910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "ME 50910",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "03927",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry P Swenson Ziebell, ARNP
• Murtaza Hamid Syed, M.D.
• Daphney Sylla, M.S.W.
• Lyndsay Kay Roseann Szerletich, MSW, RCSWI
• T.P.D.S., Inc.
• Tactical Management Inc.
• Monica Denee Taffinder
• John Taggart, MD
• Nicole Taiwo
• Michael C Talaa, PA-C

• MOHS-Micrographic Surgery Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• MOHS-Micrographic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.