| M Taveras Psyd & Company Psychological Services | |
|
13741 Bartram Park Blvd Ste 805 Jacksonville FL 32256-8074 | |
| (904) 373-8427 | |
| Not Available |
| Full Name | M Taveras Psyd & Company Psychological Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 13741 Bartram Park Blvd Ste 805, Jacksonville, Florida |
| Authorized Official Name and Position | Michelle Christy Taveras (OWNER/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 3472512090 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| M Taveras Psyd & Company Psychological Services 13241 Bartram Park Blvd Unit 805 Jacksonville FL 32258-5216 Ph: (904) 373-8427 | M Taveras Psyd & Company Psychological Services 13741 Bartram Park Blvd Ste 805 Jacksonville FL 32256-8074 Ph: (904) 373-8427 |
| NPI Number | 1093574592 |
|---|---|
| Provider Enumeration Date | 03/18/2024 |
| Last Update Date | 07/24/2024 |
| Certification Date | 07/17/2024 |
| Medicare PECOS PAC ID | 3870933104 |
|---|---|
| Medicare Enrollment ID | O20240502003139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093574592 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Michelle Taveras |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972886323 PECOS PAC ID: 9234374380 Enrollment ID: I20141105000110 |
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