MEDICARE: KING NOTARY SERVICES

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	176P00000X	Funeral Director

General Provider Information

NPI Number	:	1164753307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KING NOTARY SERVICES

Provider Business Mailing Address
First Line	:	PO BOX 705
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33402-0705
Country	:	US
Telephone Number	:	561-358-2049
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 PALM BEACH TRACE DR
Second Line	:
City	:	ROYAL PALM BEACH
State	:	FL
Zip	:	33411-1268
Country	:	US
Telephone Number	:	561-358-2049
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JOHN VINCENT WIGGLESWORTH
Credential	:
Telephone Number	:	561-358-2049

Provider Enumeration Date	:	01/28/2010
Last Update Date	:	01/28/2010

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Directions to “KING NOTARY SERVICES ” Practice Location

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