MEDICARE: MICHAEL A GARVIN, DPM, 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1366499485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MICHAEL A GARVIN, DPM, PA

Provider Business Mailing Address
First Line	:	1791 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5479
Country	:	US
Telephone Number	:	772-335-7171
Fax Number	:	772-335-2119

Provider Business Practice Location Address
First Line	:	235 NE 19TH DR
Second Line	:
City	:	OKEECHOBEE
State	:	FL
Zip	:	34972-1933
Country	:	US
Telephone Number	:	863-357-1166
Fax Number	:	863-357-0424

Authorized Official
Title or Position	:	OWNER/PHSICIAN
Name	:	DR. MICHAEL ALLEN GARVIN
Credential	:	DPM
Telephone Number	:	772-335-7171

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	08/22/2020

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