MEDICARE: ACE ENDEAVORS LLC

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1861543803
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACE ENDEAVORS LLC

Provider Business Mailing Address
First Line	:	PO BOX 904
Second Line	:
City	:	MANGO
State	:	FL
Zip	:	33550-0904
Country	:	US
Telephone Number	:	813-635-0595
Fax Number	:	813-635-0691

Provider Business Practice Location Address
First Line	:	3258 PARKSIDE CENTER CIRCLE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33619-0907
Country	:	US
Telephone Number	:	813-635-0595
Fax Number	:	813-635-0691

Authorized Official
Title or Position	:	CFO
Name	:	ARTHUR BARLAAN
Credential	:
Telephone Number	:	813-635-0595

Provider Enumeration Date	:	01/16/2007
Last Update Date	:	08/15/2007

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Directions to “ACE ENDEAVORS LLC ” Practice Location

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