MEDICARE: COUNTY OF PASCO OFFICE CLERK BOARD OF COUNTY COMMISSIONERS

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	3416L0300X	Land Ambulance	002358	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1134122146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNTY OF PASCO OFFICE CLERK BOARD OF COUNTY COMMISSIONERS

Provider Business Mailing Address
First Line	:	P. O. BOX 31911
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33631-3911
Country	:	US
Telephone Number	:	813-929-2729
Fax Number	:	813-995-9361

Provider Business Practice Location Address
First Line	:	4111 LAND O LAKES BLVD
Second Line	:	STE 208
City	:	LAND O LAKES
State	:	FL
Zip	:	34639-4402
Country	:	US
Telephone Number	:	813-929-2729
Fax Number	:	813-995-9361

Authorized Official
Title or Position	:	EMERGENCY SERVICES DIRECTOR
Name	:	SCOTT M CASSIN
Credential	:
Telephone Number	:	813-929-2750

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	10/31/2013

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