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NPI Code Detail

MEDICARE: MADISEN KATHLEEN TAGER CCC

MEDICARE:   MADISEN KATHLEEN TAGER  CCC
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
1235Z00000XSpeech-Language PathologistSA13455FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053746636
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADISEN KATHLEEN TAGER CCC
Provider Business Mailing Address
First Line : 7657 CITA LN
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34653-6221
Country : US
Telephone Number : 727-376-1111
Fax Number : 727-376-1113
Provider Business Practice Location Address
First Line : 7657 CITA LN
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34653-6221
Country : US
Telephone Number : 727-376-1111
Fax Number : 727-376-1113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2013
Last Update Date : 06/08/2016

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Directions to “ MADISEN KATHLEEN TAGER CCC” Practice Location

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