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NPI Code Detail

MEDICARE: MR. FRANK MICHAEL DESSAUER PA-C

MEDICARE:  MR. FRANK MICHAEL DESSAUER  PA-C
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
1363AM0700XMedical Physician Assistant

General Provider Information

NPI Number : 1629069570
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. FRANK MICHAEL DESSAUER PA-C
Provider Business Mailing Address
First Line : 4316 BUCKHORN GROVES CT
Second Line :
City : VALRICO
State : FL
Zip : 33594-5951
Country : US
Telephone Number : 813-827-9759
Fax Number : 813-827-9797
Provider Business Practice Location Address
First Line : 220 GRAND REGENCY BLVD
Second Line :
City : BRANDON
State : FL
Zip : 33510-3935
Country : US
Telephone Number : 813-827-9759
Fax Number : 813-827-9797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2005
Last Update Date : 07/08/2007

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Directions to “ MR. FRANK MICHAEL DESSAUER PA-C” Practice Location

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