MEDICARE: MEDICAL CLINICS P.A.

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	261QP2300X	Primary Care Clinic/Center	ME 19488	FL

General Provider Information

NPI Number	:	1639503378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEDICAL CLINICS P.A.

Provider Business Mailing Address
First Line	:	1111 HYPOLUXO RD
Second Line	:	SUITE 107
City	:	LANTANA
State	:	FL
Zip	:	33462-4271
Country	:	US
Telephone Number	:	561-586-3400
Fax Number	:	561-585-0079

Provider Business Practice Location Address
First Line	:	1880 82ND AVE
Second Line	:	SUITE 202E
City	:	VERO BEACH
State	:	FL
Zip	:	32966-6995
Country	:	US
Telephone Number	:	772-257-6217
Fax Number	:	772-257-6219

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. STEPHEN LOUIS NEMEROFSKY
Credential	:	M.D.
Telephone Number	:	561-586-3400

Provider Enumeration Date	:	08/29/2013
Last Update Date	:	09/27/2013

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