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NPI Code Detail

MEDICARE: MS. ANN E MULLEN

MEDICARE: MS. ANN E MULLEN
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
1225100000XPhysical Therapist18662FL

General Provider Information

NPI Number : 1184820805
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ANN E MULLEN
Provider Business Mailing Address
First Line : 845 KAREN ST
Second Line :
City : PALM HARBOR
State : FL
Zip : 34684-4619
Country : US
Telephone Number : 727-215-4063
Fax Number : 727-772-8202
Provider Business Practice Location Address
First Line : 1478 JORDAN HILLS CT
Second Line :
City : CLEARWATER
State : FL
Zip : 33756-2368
Country : US
Telephone Number : 727-786-5520
Fax Number : 727-786-7088
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2007
Last Update Date : 07/08/2007

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