MEDICARE: CAROLINA MAHECHA MILLAN PT, DPT

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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1518845304
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINA MAHECHA MILLAN PT, DPT

Provider Business Mailing Address
First Line	:	7802 ANDALUSIA PL APT B
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-3276
Country	:	US
Telephone Number	:	813-777-2328
Fax Number	:

Provider Business Practice Location Address
First Line	:	15205 N DALE MABRY HWY
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-1810
Country	:	US
Telephone Number	:	813-605-4838
Fax Number	:

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

Provider Enumeration Date	:	08/21/2025
Last Update Date	:	08/21/2025

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