MEDICARE: MADELYN ALMONTE PA-C

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	363A00000X	Physician Assistant	007102	GA

General Provider Information

NPI Number	:	1518373059
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADELYN ALMONTE PA-C

Provider Business Mailing Address
First Line	:	1503 ORCHARD HILL RD
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-5709
Country	:	US
Telephone Number	:	706-812-6131
Fax Number	:	706-882-3982

Provider Business Practice Location Address
First Line	:	1503 ORCHARD HILL RD
Second Line	:
City	:	LAGRANGE
State	:	GA
Zip	:	30240-5709
Country	:	US
Telephone Number	:	706-812-6131
Fax Number	:	706-882-3982

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

Provider Enumeration Date	:	07/04/2014
Last Update Date	:	03/15/2016

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Directions to “ MADELYN ALMONTE PA-C” Practice Location

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