MEDICARE: CARIE M CIMINO

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	208100000X	Physical Medicine & Rehabilitation Physician	PTA21197	FL

General Provider Information

NPI Number	:	1467173229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARIE M CIMINO

Provider Business Mailing Address
First Line	:	1135 3RD AVE APT 203B
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-7057
Country	:	US
Telephone Number	:	443-398-1049
Fax Number	:

Provider Business Practice Location Address
First Line	:	2100 10TH AVE
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-5377
Country	:	US
Telephone Number	:	772-562-8491
Fax Number	:

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

Provider Enumeration Date	:	09/08/2022
Last Update Date	:	09/08/2022

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Directions to “ CARIE M CIMINO ” Practice Location

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