Individual
ANTONIO MARTINO MILLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
12880 COMMODITY PL, TAMPA, FL 33626-3101
(813) 343-5500
(866) 462-7445
Mailing address
PO BOX 21686, TAMPA, FL 33622-1686
(813) 343-5500
(866) 462-7445
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
50.002853
OH
363AS0400X
Surgical Physician Assistant
Primary
50.002853
OH
363AS0400X
Surgical Physician Assistant
PA 9104107
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2929333 00
—
FL
Enumeration date
05/14/2007
Last updated
07/10/2013
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