MEDICARE: DR. SCOTT ALAN GARTNER OD

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	152W00000X	Optometrist	OP1411	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144334103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT ALAN GARTNER OD

Provider Business Mailing Address
First Line	:	5944 CORAL RIDGE DR
Second Line	:	#210
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3300
Country	:	US
Telephone Number	:	954-557-5913
Fax Number	:

Provider Business Practice Location Address
First Line	:	1710 TIFFANY DR E
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-3242
Country	:	US
Telephone Number	:	561-586-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	08/08/2011

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