1164413290 NPI number — TAAVI MERI

Table of content: (NPI 1164413290)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164413290 NPI number — TAAVI MERI

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TAAVI MERI
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164413290
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4992
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEMINOLE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33775-4992
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
941-284-7164
Provider Business Mailing Address Fax Number:
877-972-9327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12512 MONTARA DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LARGO
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33773-2916
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
941-284-7164
Provider Business Practice Location Address Fax Number:
877-972-9327
Provider Enumeration Date:
10/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MERI
Authorized Official First Name:
TAAVI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
941-284-7164

Provider Taxonomy Codes

  • Taxonomy code: 261QR0208X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 335V00000X , with the licence number: 18 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 030328300 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com