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NPI Code Detail

MEDICARE: FLAVIA MYRTAJ

MEDICARE:   FLAVIA  MYRTAJ
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
1390200000XStudent in an Organized Health Care Education/Training Program
21223G0001XGeneral Practice DentistryDN30561FL

General Provider Information

NPI Number : 1295590180
Entity Type Code : Individual
Provider Name (Legal Business Name) : FLAVIA MYRTAJ
Provider Business Mailing Address
First Line : 7551 CUMBERLAND RD APT 9
Second Line :
City : SEMINOLE
State : FL
Zip : 33777-2004
Country : US
Telephone Number : 727-479-7643
Fax Number :
Provider Business Practice Location Address
First Line : 10427 SHELDON RD
Second Line :
City : TAMPA
State : FL
Zip : 33626-5110
Country : US
Telephone Number : 813-302-7126
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2024
Last Update Date : 07/14/2025

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Directions to “ FLAVIA MYRTAJ ” Practice Location

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