Unknown Individual – Physician Assistant, NPI 1457357949
Physician Assistant
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Unknown Individual
4902 EISENHOWER BLVD
SUITE 300
TAMPA, FL 336346310
Phone: (813) 636-2000
Fax: (813) 321-6998
Type: Mailing
10141 BIG BEND RD # 103
RIVERVIEW, FL 335787419
Phone: (813) 397-1274
Fax: (813) 397-1271
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33634)
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