MEDICARE: MS. TI'ARRA DOMINIQUE LEE MCMILLIAN LPN

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	164W00000X	Licensed Practical Nurse	PN5226312	FL

General Provider Information

NPI Number	:	1013417922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. TI'ARRA DOMINIQUE LEE MCMILLIAN LPN

Provider Business Mailing Address
First Line	:	5038 TEMPLE HEIGHTS RD APT 30
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33617-4626
Country	:	US
Telephone Number	:	813-451-5605
Fax Number	:

Provider Business Practice Location Address
First Line	:	2212 E HENRY AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33610-4433
Country	:	US
Telephone Number	:	813-239-8069
Fax Number	:

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

Provider Enumeration Date	:	02/16/2018
Last Update Date	:	02/16/2018

Similar Medicare Providers

1619645785 — IBIS HEALTHCARE INC
Practice Location Address:

2212 E HENRY AVE
TAMPA, FL
33610-4433

Practice Phone: 813-239-8069
Practice Fax: 813-231-7324

1194915090 — DR. BHASKAR S ARYA MD
Practice Location Address:

2212 E HENRY AVE
TAMPA, FL
33610-4433

Practice Phone: 813-272-3227
Practice Fax:

1285029165 — DANIELLE EATON LMHC
Practice Location Address:

2212 E HENRY AVE
TAMPA, FL
33610-4433

Practice Phone: 386-336-0793
Practice Fax:

1811956113 — ALL BAY MEDICAL INC
Practice Location Address:

4433 GUNN HWY
TAMPA, FL
33618-8731

Practice Phone: 813-963-2438
Practice Fax: 813-963-2564

1740302645 — ITALY SHOE LAB, INC
Practice Location Address:

9639 PALM RIVER RD
TAMPA, FL
33619-4433

Practice Phone: 813-744-5155
Practice Fax:

1952542482 — MEDIWEDGE INC
Practice Location Address:

9631 PALM RIVER RD
TAMPA, FL
33619-4433

Practice Phone: 813-623-1199
Practice Fax:

Directions to “ MS. TI'ARRA DOMINIQUE LEE MCMILLIAN LPN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.