MEDICARE: MICHAEL J POFF LCSW, PA

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	1041C0700X	Clinical Social Worker	SW0003019	FL

General Provider Information

NPI Number	:	1871782003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J POFF LCSW, PA

Provider Business Mailing Address
First Line	:	1325 W FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3310
Country	:	US
Telephone Number	:	813-964-5684
Fax Number	:	813-908-2880

Provider Business Practice Location Address
First Line	:	1325 W FLETCHER AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-3310
Country	:	US
Telephone Number	:	813-964-5684
Fax Number	:	813-908-2880

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

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	12/12/2011

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