MEDICARE: MS. JOY ARLENE MCDONALD PTA, LMT

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	172V00000X	Community Health Worker	PTA19327	FL
2	172V00000X	Community Health Worker	MA46770	FL

General Provider Information

NPI Number	:	1629225453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JOY ARLENE MCDONALD PTA, LMT

Provider Business Mailing Address
First Line	:	8145 CAMPBELL CT
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-2435
Country	:	US
Telephone Number	:	727-514-4680
Fax Number	:

Provider Business Practice Location Address
First Line	:	8145 CAMPBELL CT
Second Line	:
City	:	NEW PORT RICHEY
State	:	FL
Zip	:	34653-2435
Country	:	US
Telephone Number	:	727-514-4680
Fax Number	:

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

Provider Enumeration Date	:	08/22/2008
Last Update Date	:	09/29/2009

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