MEDICARE: AMINA MALIKA PRATT-EUGENE

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	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	20233	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1609405588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMINA MALIKA PRATT-EUGENE

Provider Business Mailing Address
First Line	:	PO BOX 47223
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33646-0111
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2710 REW CIR STE 200
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-2967
Country	:	US
Telephone Number	:	888-373-0013
Fax Number	:

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

Provider Enumeration Date	:	04/03/2020
Last Update Date	:	06/01/2026

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