MEDICARE: DR. MILDRED E. PAZMINO-VERA M.D.

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	207Q00000X	Family Medicine Physician	ME68352	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	080097670	OTHER	FL	RAILROAD MEDICARE NUMBER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1639125107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILDRED E. PAZMINO-VERA M.D.

Provider Business Mailing Address
First Line	:	10051 5TH ST N STE 200
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-2211
Country	:	US
Telephone Number	:	727-824-0780
Fax Number	:	813-930-6360

Provider Business Practice Location Address
First Line	:	3675 W WATERS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33614-2783
Country	:	US
Telephone Number	:	813-915-2000
Fax Number	:	813-930-6360

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	06/14/2021

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Directions to “ DR. MILDRED E. PAZMINO-VERA M.D.” Practice Location

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