Individual provider · Type 1 NPI

Mia Jo Taveroni

Physician Assistant · Fredericksburg, VA

NPI number 1205793502 Active

Practice location

10 Stafford Lakes Pkwy Ste 102
Fredericksburg, VA 22406-7305

Call (540) 741-6982 Map

Mailing address

1340 Central Park Blvd Ste 100
Fredericksburg, VA 22401-4940

Other practice locations

955 Wonder Rd Ste C, Stafford, VA 22554-7798 · (540) 741-7890
648 Mariann Pl, Township Of Washington, NJ 07676-3934 · (201) 663-0933
11131 Journal Pkwy Ste A, King George, VA 22485-3468 · (540) 741-6982

Specialties and licenses

Taxonomy	Code	License
Physician Assistant Primary	363A00000X	0110011893 (VA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1205793502

Mia Jo Taveroni's National Provider Identifier is 1205793502, issued on Jan 7, 2026. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Fredericksburg, VA. The record was last updated on Jun 8, 2026.