| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MICHAEL C TAVARES | 1558089276 | 2022-08-18 |
Michael C Tavares is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1558089276. Registration indicates Michael C Tavares is a provider of access to mental health/behavioral health providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Psych/Mental Health, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Psych/Mental Health, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| Entity Type | Individual |
| Provider Name | Mr. Michael C Tavares PMHNP-BC |
| Practice Office Address | 1221 W LAKEVIEW AVE PENSACOLA, FL US |
| Practice Office Telephone | 8504693500 |
| Mailing Address | 1221 W LAKEVIEW AVE PENSACOLA, FL 325011836 US |
| Business Telephone | 8504693500 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 6119 Hilburn Rd | Pensacola, FL 325046218 | 8506028467 |
| Code | Practice | License No State |
|---|---|---|
| 363LP0808X PRIMARY | Access to Mental Health/Behavioral Health Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Psych/Mental Health All Other Specialties & Provider Types Nurse Practitioner Psych/Mental Health Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | APRN11022135
FL |