JUVERIA TAWWAB MD LLC (NPI# 1912394305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912394305 |
| Entity Type | Organization |
| Organization Name | JUVERIA TAWWAB MD LLC |
| Practice Address |
2605 W Lake Mary Blvd Suite# 119 Lake Mary FL 32746-3568 |
| Mailing Address |
Po Box 952824 Lake Mary FL 32795-2824 |
| Practice Telephone | 4073021331 |
| Practice Fax Number | 4076889455 |
| Mailing Telephone | 4073021331 |
| Mailing Fax Number | 4076889455 |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | JUVERIA TAWWAB (M.D.) |
| Authorized Official Telephone | 4078330610 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | ME119485 | FL | Allopathic & Osteopathic Physicians |
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
ME119485 | FL | Ambulatory Health Care Facilities |
| Street Address |
2605 W LAKE MARY BLVD SUITE# 119 |
| City | LAKE MARY |
| State | FL |
| Zip Code | 32746-3568 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174781710 | Juveria Tawwab | Family Medicine | 2605 W Lake Mary Blvd, #119, Lake Mary, FL 32746-3568 | 2008-05-30 |
| 1669913430 | Michael Bombka LLC | Clinic/Center | 2605 W Lake Mary Blvd, Lake Mary, FL 32746-3568 | 2017-03-14 |
| 1285927277 | Faisal Tawwab | Family Medicine | 2605 W Lake Mary Blvd, Suite 119, Lake Mary, FL 32746-3568 | 2011-05-24 |
| 1336376086 | Abdul Quyyum Ahmed | Family Medicine | 2605 W Lake Mary Blvd, Suite 119, Lake Mary, FL 32746-3568 | 2009-06-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286397 | James Maggert | Physical Therapist | Sst Rehab, 635 Century Pt - Suite 111, Lake Mary, FL 32746 | 2020-05-14 |
| 1225663743 | Jamie Pecot | Behavior Technician | 300 International Parkway, 200, Lake Mary, FL 32746 | 2020-03-04 |
| 1619509585 | Dental Associates of Heathrow, LLC | Dentist | Dental Associates of Heathrow, LLC, 120 International Parkway Suite 26, Heathrow, FL 32746 | 2020-02-10 |
| 1376185876 | Rinehart Road Surgery Center, LLC | Clinic/Center | 392 Rinehart Road, Suite 1100, Lake Mary, FL 32746 | 2019-10-16 |
| 1871140988 | Central Florida Wellness LLC | General Practice | 1061 S Sun Drove, Suite 1041, Lake. Mary, FL 32746 | 2019-08-22 |
| 1326609942 | Antoine Slade I | Behavior Technician | 4876 Rhinehart Road, Lake Mary, FL 32746 | 2019-06-25 |
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| 1336610856 | Olivia Laurel Stolz | Physician Assistant | 3300 West Lake Mary Blvd, 220, Lake Mary, FL 32746 | 2018-12-10 |
| 1881171072 | Elite-star Medical Transport LLC. | Non-emergency Medical Transport (VAN) | 2910 W Lake Mary Blvd Ste 101, Lake Mary, FL 32746 | 2018-07-20 |
| 1508351537 | Ariagny Elena Fereira | Speech-Language Pathologist | 145 Middle Street Suite 1101, Lake Mary, FL 32746 | 2018-06-22 |
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| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.