MEDICARE: PROXIMITI TECHNOLOGIES, 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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1659607885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROXIMITI TECHNOLOGIES, INC.

Provider Business Mailing Address
First Line	:	5410 MARINER ST
Second Line	:	SUITE 175
City	:	TAMPA
State	:	FL
Zip	:	33609-3432
Country	:	US
Telephone Number	:	813-579-1000
Fax Number	:	813-579-1005

Provider Business Practice Location Address
First Line	:	5410 MARINER ST
Second Line	:	SUITE 175
City	:	TAMPA
State	:	FL
Zip	:	33609-3432
Country	:	US
Telephone Number	:	813-579-1000
Fax Number	:	813-579-1005

Authorized Official
Title or Position	:	CFO
Name	:	DONALD CARL DAVIS
Credential	:
Telephone Number	:	813-579-1036

Provider Enumeration Date	:	10/22/2009
Last Update Date	:	10/22/2009

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