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NPI Code Detail

MEDICARE: DR. FITSUM YOHANNES-PETERS MD

MEDICARE: DR. FITSUM YOHANNES-PETERS MD
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
1207PE0005XUndersea and Hyperbaric Medicine (Emergency Medicine) PhysicianME92187FL
2207P00000XEmergency Medicine PhysicianME92187FL
3207PH0002XHospice and Palliative Medicine (Emergency Medicine) PhysicianME92187FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00675105OTHERFLRAILROAD MEDICARE PIN
3P00280671OTHERFLRAILROAD MEDICARE PIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982660106
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FITSUM YOHANNES-PETERS MD
Provider Business Mailing Address
First Line : 2600 BRUCE B DOWNS BLVD STE 102
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-9207
Country : US
Telephone Number : 813-929-5590
Fax Number : 813-929-5596
Provider Business Practice Location Address
First Line : 2600 BRUCE B DOWNS BLVD STE 102
Second Line :
City : WESLEY CHAPEL
State : FL
Zip : 33544-9207
Country : US
Telephone Number : 813-929-5590
Fax Number : 813-929-5596
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/25/2006
Last Update Date : 03/30/2022

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Directions to “ DR. FITSUM YOHANNES-PETERS MD” Practice Location

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