MEDICARE: MARINA WAISMAN MD STEVEN YALE MD 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	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1831316868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARINA WAISMAN MD STEVEN YALE MD PA

Provider Business Mailing Address
First Line	:	17407 BRIDGE HILL CT STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-971-1800
Fax Number	:	813-971-1804

Provider Business Practice Location Address
First Line	:	17407 BRIDGE HILL CT STE A
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33647-3522
Country	:	US
Telephone Number	:	813-971-1800
Fax Number	:	813-971-1804

Authorized Official
Title or Position	:	OFFICER
Name	:	MARINA WAISMAN
Credential	:	M.D.
Telephone Number	:	813-971-1800

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	12/12/2007

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