MEDICARE: DR. MARY J KING DO

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	207R00000X	Internal Medicine Physician	OS0007369	FL

General Provider Information

NPI Number	:	1255338083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY J KING DO

Provider Business Mailing Address
First Line	:	PO BOX 850001, DEPT 8340
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32885-0001
Country	:	US
Telephone Number	:	813-536-7277
Fax Number	:	855-830-1722

Provider Business Practice Location Address
First Line	:	10225 ULMERTON RD STE 1A
Second Line	:
City	:	LARGO
State	:	FL
Zip	:	33771-3522
Country	:	US
Telephone Number	:	727-585-7408
Fax Number	:	866-980-2443

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	11/11/2025

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