MEDICARE: MARIA NAZARIO LMT

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	172V00000X	Community Health Worker	MA60221	FL

General Provider Information

NPI Number	:	1457660367
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA NAZARIO LMT

Provider Business Mailing Address
First Line	:	12606 SOPHIAMARIE LOOP
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7177
Country	:	US
Telephone Number	:	407-948-5345
Fax Number	:	407-704-5011

Provider Business Practice Location Address
First Line	:	12606 SOPHIAMARIE LOOP
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32828-7177
Country	:	US
Telephone Number	:	407-948-5345
Fax Number	:	407-704-5011

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

Provider Enumeration Date	:	09/27/2010
Last Update Date	:	09/27/2010

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