MEDICARE: SAMUEL G SCIME MD 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	207W00000X	Ophthalmology Physician	15470	FL

General Provider Information

NPI Number	:	1487634556
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL G SCIME MD PA

Provider Business Mailing Address
First Line	:	7401 NORTH UNIVERSITY DRIVE
Second Line	:	SUITE 202
City	:	TAMARAC
State	:	FL
Zip	:	33321-2919
Country	:	US
Telephone Number	:	954-721-8330
Fax Number	:	954-721-8330

Provider Business Practice Location Address
First Line	:	7401 NORTH UNIVERSITY DRIVE
Second Line	:	SUITE 202
City	:	TAMARAC
State	:	FL
Zip	:	33321-2919
Country	:	US
Telephone Number	:	954-721-8330
Fax Number	:	954-721-8330

Authorized Official
Title or Position	:	OWNER PRESIDENT
Name	:	MR. SAMUEL G SCIME
Credential	:	MD
Telephone Number	:	954-721-8330

Provider Enumeration Date	:	01/17/2006
Last Update Date	:	03/04/2008

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