MEDICARE: KIMBERLY MELARAGNI

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	225200000X	Physical Therapy Assistant	PTA27363	FL

General Provider Information

NPI Number	:	1811420516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MELARAGNI

Provider Business Mailing Address
First Line	:	12512 REGENCY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-6542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12512 REGENCY ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33625-6542
Country	:	US
Telephone Number	:	813-843-6262
Fax Number	:

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

Provider Enumeration Date	:	04/10/2017
Last Update Date	:	04/10/2017

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Directions to “ KIMBERLY MELARAGNI ” Practice Location

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