MEDICARE: DR. MARY LEE JOSEY 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	207VG0400X	Gynecology Physician	ME0053792	FL

General Provider Information

NPI Number	:	1841293289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY LEE JOSEY M.D.

Provider Business Mailing Address
First Line	:	508 S HABANA AVE
Second Line	:	STE 350
City	:	TAMPA
State	:	FL
Zip	:	33609-4181
Country	:	US
Telephone Number	:	813-873-1426
Fax Number	:	813-873-1824

Provider Business Practice Location Address
First Line	:	508 S HABANA AVE
Second Line	:	STE 350
City	:	TAMPA
State	:	FL
Zip	:	33609-4181
Country	:	US
Telephone Number	:	813-873-1426
Fax Number	:	813-873-1824

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	09/30/2008

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