MEDICARE: DR. JIMMY ZIMING TAO M.D.

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	ME108530	FL
2	207ZC0500X	Cytopathology Physician	A113234	CA
3	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	A113234	CA

General Provider Information

NPI Number	:	1689955288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JIMMY ZIMING TAO M.D.

Provider Business Mailing Address
First Line	:	8920 NW 8TH ST
Second Line	:	APT 204
City	:	MIAMI
State	:	FL
Zip	:	33172-3426
Country	:	US
Telephone Number	:	917-536-8084
Fax Number	:

Provider Business Practice Location Address
First Line	:	8920 NW 8TH ST
Second Line	:	APT 204
City	:	MIAMI
State	:	FL
Zip	:	33172-3426
Country	:	US
Telephone Number	:	917-536-8084
Fax Number	:

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

Provider Enumeration Date	:	09/09/2011
Last Update Date	:	06/16/2020

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