MEDICARE: CHIRIGA THOMAS

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	103TR0400X	Rehabilitation Psychologist

General Provider Information

NPI Number	:	1417313768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHIRIGA THOMAS

Provider Business Mailing Address
First Line	:	5818 FOLKSTONE LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-9410
Country	:	US
Telephone Number	:	407-715-0475
Fax Number	:

Provider Business Practice Location Address
First Line	:	5818 FOLKSTONE LN
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-9410
Country	:	US
Telephone Number	:	407-715-0475
Fax Number	:

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

Provider Enumeration Date	:	01/01/2016
Last Update Date	:	01/01/2016

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Directions to “ CHIRIGA THOMAS ” Practice Location

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