Dibert, Tavenner Tathen
Dibert, Tavenner Tathen is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Cardiology, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine is her primary health care specialty. Dibert, Tavenner Tathen can be contacted via phone (352) 273-9001.Contact Information
Primary practice address
1600 Sw Archer Rd
Gainesville FL 32610-3003
Phone: (352) 273-9001
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Cardiology | 2080P0202X | ME140590 | Florida |
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | ME140590 | Florida |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ME140590 | Florida |
Profile Details
| NPI number | 1649627381 |
|---|---|
| LBN Legal business name | Dibert, Tavenner Tathen |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 23rd, 2016 |
| Last updated | Aug 8th, 2024 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649627381 | NPPES |
| Florida | MEDICAID | 123082700 |
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