| Provider / Organization | NPI | Date Certified |
|---|---|---|
| KEIVAN A TAVAKOLI | 1386242253 | 2022-11-23 |
Keivan A Tavakoli is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1386242253. Registration indicates Keivan A Tavakoli is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, General Practice Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, General Practice) (Allopathic & Osteopathic Physicians, General Practice) (General Practice, ) (Primary Care/Family Planning/APRN/PA, ) (General Practice, Allopathic & Osteopathic Physicians)
| Entity Type | Individual |
| Provider Name | Dr. Keivan A Tavakoli MD |
| Practice Office Address | 5350 SPRING HILL DR SPRING HILL, FL US |
| Practice Office Telephone | 3526888116 |
| Practice Office Fax | 3526869477 |
| Mailing Address | 5400 PINEHURST DR # D5 SPRING HILL, FL 346063833 US |
| Business Telephone | 3522775305 |
| Business Fax | 3526160926 |
| Code | Practice | License No State |
|---|---|---|
| 208D00000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians General PracticeAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians General Practice Allopathic & Osteopathic Physicians General Practice General Practice Primary Care/Family Planning/APRN/PA General Practice Allopathic & Osteopathic Physicians | ACN1322
FL |