MEDICARE: MR. MESFIN T ARAYA

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	343900000X	Non-emergency Medical Transport (VAN)		FL

General Provider Information

NPI Number	:	1073038287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MESFIN T ARAYA

Provider Business Mailing Address
First Line	:	4403 AKITA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624-1103
Country	:	US
Telephone Number	:	813-996-1111
Fax Number	:

Provider Business Practice Location Address
First Line	:	4403 AKITA DR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33624
Country	:	US
Telephone Number	:	813-996-1111
Fax Number	:

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

Provider Enumeration Date	:	08/09/2017
Last Update Date	:	07/21/2022

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