MEDICARE: REED S EDELMAN 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
1	152W00000X	Optometrist	OPC1828	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	:	1427208594
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REED S EDELMAN OD PA

Provider Business Mailing Address
First Line	:	7124 BERACASA WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3448
Country	:	US
Telephone Number	:	561-750-7744
Fax Number	:	561-392-3200

Provider Business Practice Location Address
First Line	:	7124 BERACASA WAY
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33433-3448
Country	:	US
Telephone Number	:	561-750-7744
Fax Number	:	561-392-3200

Authorized Official
Title or Position	:	PRESIDENT OPTOMETRIST
Name	:	DR. REED S EDELMAN
Credential	:	OD
Telephone Number	:	561-750-7774

Provider Enumeration Date	:	09/25/2008
Last Update Date	:	11/02/2010

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