MEDICARE: DR. RITA T MAPA 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	208000000X	Pediatrics Physician	ME83031	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841288990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RITA T MAPA MD

Provider Business Mailing Address
First Line	:	4930 E LAKE MARY BLVD
Second Line	:
City	:	SANFORD
State	:	FL
Zip	:	32771-5003
Country	:	US
Telephone Number	:	407-322-8645
Fax Number	:	407-324-7311

Provider Business Practice Location Address
First Line	:	6101 LAKE ELLENOR DR
Second Line	:	SUITE 105
City	:	ORLANDO
State	:	FL
Zip	:	32809
Country	:	US
Telephone Number	:	407-322-8645
Fax Number	:	407-956-4676

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

Provider Enumeration Date	:	10/12/2005
Last Update Date	:	09/03/2020

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