MEDICARE: DR. MARIA JOSEPHINE RAZON M.D.

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	174400000X	Specialist	ME 93566	FL
2	207R00000X	Internal Medicine Physician	ME93566	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1417919036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIA JOSEPHINE RAZON M.D.

Provider Business Mailing Address
First Line	:	10051 5TH ST N STE 200
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-2211
Country	:	US
Telephone Number	:	727-824-0780
Fax Number	:	813-514-8891

Provider Business Practice Location Address
First Line	:	772 CORTARO DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6811
Country	:	US
Telephone Number	:	813-633-9443
Fax Number	:	813-633-9502

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

Provider Enumeration Date	:	04/06/2006
Last Update Date	:	03/11/2020

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