MEDICARE: MADISON LAPORTE RD

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	133V00000X	Registered Dietitian	ND7839	FL

General Provider Information

NPI Number	:	1578199709
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON LAPORTE RD

Provider Business Mailing Address
First Line	:	PO BOX 1289
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33601-1289
Country	:	US
Telephone Number	:	813-844-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 TAMPA GENERAL CIR
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33606-3571
Country	:	US
Telephone Number	:	813-844-3326
Fax Number	:

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

Provider Enumeration Date	:	03/19/2020
Last Update Date	:	01/08/2026

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