MEDICARE: MICHAEL R CARPINO PA-C

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	363A00000X	Physician Assistant	9120363	FL

General Provider Information

NPI Number	:	1194431346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL R CARPINO PA-C

Provider Business Mailing Address
First Line	:	151 SOUTHHALL LN STE 300
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-7172
Country	:	US
Telephone Number	:	866-400-3376
Fax Number	:	386-738-0628

Provider Business Practice Location Address
First Line	:	600 W PLYMOUTH AVE
Second Line	:
City	:	DELAND
State	:	FL
Zip	:	32720-2709
Country	:	US
Telephone Number	:	866-400-3376
Fax Number	:	386-738-0628

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

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	12/04/2025

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