MEDICARE: DOMINIC PRADO MD

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	207W00000X	Ophthalmology Physician	168475	FL

General Provider Information

NPI Number	:	1649808437
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOMINIC PRADO MD

Provider Business Mailing Address
First Line	:	7522 N HIMES AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3205
Country	:	US
Telephone Number	:	813-931-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7522 N HIMES AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3205
Country	:	US
Telephone Number	:	813-931-0500
Fax Number	:

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

Provider Enumeration Date	:	03/29/2020
Last Update Date	:	03/03/2026

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Directions to “ DOMINIC PRADO MD” Practice Location

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