MEDICARE: RAZON & ALARCON MANAGEMENT INC.

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	207R00000X	Internal Medicine Physician	ME0093566	FL

General Provider Information

NPI Number	:	1639211030
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAZON & ALARCON MANAGEMENT INC.

Provider Business Mailing Address
First Line	:	772 CORTARO DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6811
Country	:	US
Telephone Number	:	813-633-9443
Fax Number	:	813-633-9502

Provider Business Practice Location Address
First Line	:	772 CORTARO DR
Second Line	:
City	:	RUSKIN
State	:	FL
Zip	:	33573-6811
Country	:	US
Telephone Number	:	813-633-9443
Fax Number	:	813-633-9502

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. JON A. RAZON
Credential	:
Telephone Number	:	813-633-9443

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	01/22/2008

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