MEDICARE: MILTON K MACIAS PT, DPT, COMT, OCS

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	225100000X	Physical Therapist	PT26644	FL

General Provider Information

NPI Number	:	1275811960
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MILTON K MACIAS PT, DPT, COMT, OCS

Provider Business Mailing Address
First Line	:	2307 S DALE MABRY HWY STE F
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6322
Country	:	US
Telephone Number	:	813-374-9508
Fax Number	:	813-443-5599

Provider Business Practice Location Address
First Line	:	2307 S DALE MABRY HWY STE F
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33629-6322
Country	:	US
Telephone Number	:	813-374-9508
Fax Number	:	813-443-5599

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

Provider Enumeration Date	:	07/28/2011
Last Update Date	:	07/21/2025

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