MEDICARE: MRS. VERONICA BINTNER PA

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	363AM0700X	Medical Physician Assistant	25MP00207400	NJ
2	363A00000X	Physician Assistant	25MP00207400	NJ

General Provider Information

NPI Number	:	1396097853
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. VERONICA BINTNER PA

Provider Business Mailing Address
First Line	:	200 2ND AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4313
Country	:	US
Telephone Number	:	727-291-9538
Fax Number	:	727-293-5154

Provider Business Practice Location Address
First Line	:	200 2ND AVE S
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33701-4313
Country	:	US
Telephone Number	:	727-291-9538
Fax Number	:	727-293-5154

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

Provider Enumeration Date	:	10/09/2012
Last Update Date	:	11/22/2023

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