Provider Demographics
NPI:1134439284
Name:ANTHONY M MESSINA MD PA
Entity type:Organization
Organization Name:ANTHONY M MESSINA MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:M
Authorized Official - Last Name:MESSINA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-879-0233
Mailing Address - Street 1:2502 W SAINT ISABEL ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6370
Mailing Address - Country:US
Mailing Address - Phone:813-879-0233
Mailing Address - Fax:813-879-6211
Practice Address - Street 1:2502 W SAINT ISABEL ST
Practice Address - Street 2:SUITE A
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6370
Practice Address - Country:US
Practice Address - Phone:813-879-0233
Practice Address - Fax:813-879-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0023773174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL71701Medicare PIN