MEDICARE: DR. PAWAN KUMAR RATTAN MD

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	207V00000X	Obstetrics & Gynecology Physician	ME40193	FL

General Provider Information

NPI Number	:	1245659010
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PAWAN KUMAR RATTAN MD

Provider Business Mailing Address
First Line	:	612 E DAVIS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3922
Country	:	US
Telephone Number	:	813-222-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	612 E DAVIS BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3922
Country	:	US
Telephone Number	:	813-222-2000
Fax Number	:

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

Provider Enumeration Date	:	04/09/2014
Last Update Date	:	08/11/2014

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