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NPI Code Detail

MEDICARE: MIA PAGANO

MEDICARE: MIA PAGANO
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
12255A2300XAthletic Trainer

General Provider Information

NPI Number : 1124597596
Entity Type Code : Individual
Provider Name (Legal Business Name) : MIA PAGANO
Provider Business Mailing Address
First Line : 2901 W SAN JOSE ST
Second Line :
City : TAMPA
State : FL
Zip : 33629-7257
Country : US
Telephone Number : 551-579-0463
Fax Number :
Provider Business Practice Location Address
First Line : 401 W KENNEDY BLVD
Second Line :
City : TAMPA
State : FL
Zip : 33606-1490
Country : US
Telephone Number : 813-253-3333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2018
Last Update Date : 11/15/2018

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Directions to “ MIA PAGANO ” Practice Location

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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.

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