MEDICARE: MS. IRMA C WILLCUT D.O.

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	156FX1800X	Optician	2758	FL

General Provider Information

NPI Number	:	1558400275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. IRMA C WILLCUT D.O.

Provider Business Mailing Address
First Line	:	3233 W COLUMBUS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1852
Country	:	US
Telephone Number	:	813-871-5765
Fax Number	:	813-873-7345

Provider Business Practice Location Address
First Line	:	3233 W COLUMBUS DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1852
Country	:	US
Telephone Number	:	813-871-5765
Fax Number	:	813-873-7345

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

Provider Enumeration Date	:	02/06/2007
Last Update Date	:	07/08/2007

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