MEDICARE: MICHAEL J TOLENTINO MD

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	207W00000X	Ophthalmology Physician	ME91537	FL
2	207WX0107X	Retina Specialist (Ophthalmology) Physician	ME91537	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1639149313
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL J TOLENTINO MD

Provider Business Mailing Address
First Line	:	3280 N MCMULLEN BOOTH RD
Second Line	:	SUITE 120
City	:	CLEARWATER
State	:	FL
Zip	:	33761-2029
Country	:	US
Telephone Number	:	727-789-8770
Fax Number	:	727-789-8784

Provider Business Practice Location Address
First Line	:	3280 N MCMULLEN BOOTH RD
Second Line	:	SUITE 120
City	:	CLEARWATER
State	:	FL
Zip	:	33761-2029
Country	:	US
Telephone Number	:	727-789-8770
Fax Number	:	727-789-8784

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	07/21/2022

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Directions to “ MICHAEL J TOLENTINO MD” Practice Location

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