Provider Demographics
NPI:1497759161
Name:FRANK D TAGLIARINI MD PA
Entity Type:Organization
Organization Name:FRANK D TAGLIARINI MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KLAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-971-2300
Mailing Address - Street 1:3010 E 138TH AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3904
Mailing Address - Country:US
Mailing Address - Phone:813-971-2300
Mailing Address - Fax:813-971-2311
Practice Address - Street 1:3010 E 138TH AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-3904
Practice Address - Country:US
Practice Address - Phone:813-971-2300
Practice Address - Fax:813-971-2311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-09
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME13823261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4104985OtherAETNA
29611OtherBLUE CROSS/BLUE SHIELD
111686970OtherRAILROAD MEDICARE
D53638Medicare UPIN
FL29611Medicare PIN