MEDICARE: ERIN MCENTEGART MSW

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	1041C0700X	Clinical Social Worker	ISW12446	FL

General Provider Information

NPI Number	:	1194339663
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MCENTEGART MSW

Provider Business Mailing Address
First Line	:	4719 W FAIR OAKS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-2117
Country	:	US
Telephone Number	:	727-723-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	4719 W FAIR OAKS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33611-2117
Country	:	US
Telephone Number	:	727-723-5299
Fax Number	:

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

Provider Enumeration Date	:	09/02/2020
Last Update Date	:	09/02/2020

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