MEDICARE: DR. ILKA YADIRA NAZARIO 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	208000000X	Pediatrics Physician	ME92944	FL
2	207R00000X	Internal Medicine Physician	ME92944	FL
3	207R00000X	Internal Medicine Physician	036158035	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	036.158035	OTHER	IL	IL MEDICAL LICENSE
2	ME92944	OTHER	FL	FL MEDICAL LICENSE

General Provider Information

NPI Number	:	1992755896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ILKA YADIRA NAZARIO M.D.

Provider Business Mailing Address
First Line	:	3355 W BEARSS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2100
Country	:	US
Telephone Number	:	813-893-5430
Fax Number	:	813-608-0319

Provider Business Practice Location Address
First Line	:	3355 W BEARSS AVE
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33618-2100
Country	:	US
Telephone Number	:	813-893-5430
Fax Number	:

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	11/12/2025

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