MEDICARE: DR. CATHERINE FIEDLER O D 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	152W00000X	Optometrist	OPC 3582	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	OPC 3582	OTHER	FL	LICENSE NUMBER

General Provider Information

NPI Number	:	1730393083
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE FIEDLER O D P A

Provider Business Mailing Address
First Line	:	10821 BITTERNUT HICKORY LN
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437
Country	:	US
Telephone Number	:	561-734-5373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3345 S. CONGRESS AVE
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33461
Country	:	US
Telephone Number	:	561-964-0220
Fax Number	:

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

Provider Enumeration Date	:	05/09/2007
Last Update Date	:	06/02/2010

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