MEDICARE: MR. JAMES MICHAEL BRUMLEY 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

General Provider Information

NPI Number	:	1235128521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES MICHAEL BRUMLEY PA-C

Provider Business Mailing Address
First Line	:	16622 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1400
Country	:	US
Telephone Number	:	813-948-7550
Fax Number	:

Provider Business Practice Location Address
First Line	:	16622 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1400
Country	:	US
Telephone Number	:	813-948-7550
Fax Number	:

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	08/22/2016

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