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NPI Code Detail

MEDICARE: TAMMY WEDEL

MEDICARE: TAMMY WEDEL
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
1246ZA2600XMedical Art Specialist/Technologist29-BID-2100056FL

General Provider Information

NPI Number : 1619377298
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMMY WEDEL
Provider Business Mailing Address
First Line : 6822 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33634-2212
Country : US
Telephone Number : 813-505-1113
Fax Number :
Provider Business Practice Location Address
First Line : 6822 W WATERS AVE
Second Line :
City : TAMPA
State : FL
Zip : 33634-2212
Country : US
Telephone Number : 813-505-1113
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2014
Last Update Date : 09/02/2014

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Directions to “ TAMMY WEDEL ” Practice Location

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