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NPI Code Detail

MEDICARE: TAMRA RENAE ASSUMPCAO P.A.-C

MEDICARE: TAMRA RENAE ASSUMPCAO P.A.-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
1363AM0700XMedical Physician AssistantPAX00006908FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316119514
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMRA RENAE ASSUMPCAO P.A.-C
Provider Business Mailing Address
First Line : PO BOX 2066
Second Line :
City : LECANTO
State : FL
Zip : 34460-2066
Country : US
Telephone Number : 352-563-0931
Fax Number : 352-527-8818
Provider Business Practice Location Address
First Line : 1990 N PROSPECT AVE
Second Line :
City : LECANTO
State : FL
Zip : 34461-9792
Country : US
Telephone Number : 352-527-6888
Fax Number : 352-527-8818
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2008
Last Update Date : 10/19/2021

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