MEDICARE: FRANCITA TADOR PA

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	363A00000X	Physician Assistant	PA9106067	FL
2	363AM0700X	Medical Physician Assistant	PA9106067	FL

General Provider Information

NPI Number	:	1770902082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCITA TADOR PA

Provider Business Mailing Address
First Line	:	915 NE 135TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4128
Country	:	US
Telephone Number	:	786-423-3400
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 NE 135TH ST
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33161-4128
Country	:	US
Telephone Number	:	786-423-3400
Fax Number	:

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

Provider Enumeration Date	:	04/15/2014
Last Update Date	:	04/15/2014

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Directions to “ FRANCITA TADOR PA” Practice Location

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