MEDICARE: BELLE GLADE EMERGENCY PHYSICIANS LLC

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	207P00000X	Emergency Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	34282	OTHER	FL	BCBS OF FL

General Provider Information

NPI Number	:	1083631774
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELLE GLADE EMERGENCY PHYSICIANS LLC

Provider Business Mailing Address
First Line	:	861 SW 78TH AVE
Second Line	:	SUITE #100B
City	:	PLANTATION
State	:	FL
Zip	:	33324-3273
Country	:	US
Telephone Number	:	954-693-0000
Fax Number	:	954-693-0005

Provider Business Practice Location Address
First Line	:	1201 S MAIN ST
Second Line	:	EMERGENCY DEPARTMENT
City	:	BELLE GLADE
State	:	FL
Zip	:	33430-4911
Country	:	US
Telephone Number	:	954-693-0000
Fax Number	:	954-693-0005

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	DR. DAVID SCOTT SCHILLINGER
Credential	:	M.D.
Telephone Number	:	954-693-0000

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	12/12/2007

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