MEDICARE: ADAM FELDMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	22115	FL

General Provider Information

NPI Number	:	1245785930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ADAM FELDMAN

Provider Business Mailing Address
First Line	:	502 S FREMONT AVE
Second Line	:	#1430
City	:	TAMPA
State	:	FL
Zip	:	33606-2068
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5101 E BUSCH BLVD
Second Line	:	#13
City	:	TAMPA
State	:	FL
Zip	:	33617-5380
Country	:	US
Telephone Number	:	813-988-1167
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/23/2016
Last Update Date	:	08/23/2016

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Directions to “ ADAM FELDMAN ” Practice Location

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