Basic Information
| Provider Information | |||||||||
| NPI: | 1629608021 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAFUTO | ||||||||
| FirstName: | BRIANA | ||||||||
| MiddleName: | FILOMENA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14130 DUKE HWY | ||||||||
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| City: | ALVA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 339203000 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 901 W BEN WHITE BLVD | ||||||||
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| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787046903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124472211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2020 | ||||||||
| LastUpdateDate: | 06/18/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/18/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | 929170 | TX | N | Nursing Service Providers | Registered Nurse | 367500000X | AP146170 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered |
No ID Information.