MEDICARE: DR. BENJAMIN P LOVE MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	10901	OK
2	207ZH0000X	Hematology (Pathology) Physician	10901	OK

General Provider Information

NPI Number	:	1245219468
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN P LOVE MD

Provider Business Mailing Address
First Line	:	7111 FAIRWAY DR
Second Line	:	SUITE 400
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-4204
Country	:	US
Telephone Number	:	561-712-6265
Fax Number	:	561-712-7349

Provider Business Practice Location Address
First Line	:	3000 UNITED FOUNDERS BLVD
Second Line	:	SUITE 234
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-3958
Country	:	US
Telephone Number	:	405-842-2061
Fax Number	:	405-842-3146

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

Provider Enumeration Date	:	01/16/2006
Last Update Date	:	10/12/2007

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