Provider Demographics
NPI:1679561294
Name:TACHE, JASON (DO)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:
Last Name:TACHE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7351 W OAKLAND PARK BLVD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:TAMARAC
Mailing Address - State:FL
Mailing Address - Zip Code:33319-7107
Mailing Address - Country:US
Mailing Address - Phone:954-749-6955
Mailing Address - Fax:954-578-2783
Practice Address - Street 1:8200 W SUNRISE BLVD BLDG C
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5426
Practice Address - Country:US
Practice Address - Phone:954-370-8585
Practice Address - Fax:954-370-1585
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8847207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology