MEDICARE: WILLIAM AARON MANN

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	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1205393055
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM AARON MANN

Provider Business Mailing Address
First Line	:	13702 N 42ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4803
Country	:	US
Telephone Number	:	607-221-7044
Fax Number	:

Provider Business Practice Location Address
First Line	:	13702 N 42ND ST
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33613-4803
Country	:	US
Telephone Number	:	607-221-7044
Fax Number	:

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

Provider Enumeration Date	:	02/28/2019
Last Update Date	:	02/28/2019

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Directions to “ WILLIAM AARON MANN ” Practice Location

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