MEDICARE: DR. GABRIELE F. RODEN M.D.

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	207L00000X	Anesthesiology Physician	38648	MA
2	207L00000X	Anesthesiology Physician	ME88576	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548241508
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GABRIELE F. RODEN M.D.

Provider Business Mailing Address
First Line	:	7103 FAIRWAY DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3701
Country	:	US
Telephone Number	:	561-515-1500
Fax Number	:

Provider Business Practice Location Address
First Line	:	7103 FAIRWAY DR
Second Line	:	BASCOM PALMER EYE INSTITUTE
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3701
Country	:	US
Telephone Number	:	561-515-1500
Fax Number	:

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	10/25/2007

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