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NPI Code Detail

MEDICARE: WAYNE P TEPPER OD PA

MEDICARE: WAYNE P TEPPER OD PA
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
1152W00000XOptometristOPC1118FL

General Provider Information

NPI Number : 1154595726
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAYNE P TEPPER OD PA
Provider Business Mailing Address
First Line : 333 PLAZA REAL
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-3938
Country : US
Telephone Number : 561-392-8383
Fax Number :
Provider Business Practice Location Address
First Line : 333 PLAZA REAL
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-3938
Country : US
Telephone Number : 561-392-8383
Fax Number :
Authorized Official
Title or Position : MEDICAL BILLING
Name : MRS. KIRSTEN NUGENT
Credential :
Telephone Number : 561-392-8383
Provider Enumeration Date : 04/15/2008
Last Update Date : 04/15/2008

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Directions to “WAYNE P TEPPER OD PA ” Practice Location

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