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NPI Code Detail

MEDICARE: MICHAEL A GARVIN DPM PA

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
1332B00000XDurable Medical Equipment & Medical SuppliesPO1984FL

General Provider Information

NPI Number : 1659623700
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 :
Provider Business Practice Location Address
First Line : 3405 NW FEDERAL HWY
Second Line :
City : JENSEN BEACH
State : FL
Zip : 34957-4439
Country : US
Telephone Number : 772-335-7171
Fax Number :
Authorized Official
Title or Position : PHYSICIAN
Name : DR. MICHAEL ALLEN GARVIN
Credential : DPM
Telephone Number : 772-335-7171
Provider Enumeration Date : 10/12/2012
Last Update Date : 10/15/2012

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