MEDICARE: FERNANDO TAPIA 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	207VG0400X	Gynecology Physician	ME0022216	FL

General Provider Information

NPI Number	:	1669493995
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FERNANDO TAPIA M. D.

Provider Business Mailing Address
First Line	:	616 E ALTAMONTE DR STE 101
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4811
Country	:	US
Telephone Number	:	407-831-7000
Fax Number	:	407-831-5077

Provider Business Practice Location Address
First Line	:	616 E ALTAMONTE DR STE 101
Second Line	:
City	:	ALTAMONTE SPRINGS
State	:	FL
Zip	:	32701-4811
Country	:	US
Telephone Number	:	407-831-7000
Fax Number	:	407-831-5077

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	07/08/2007

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