MEDICARE: DR. GARY PEARCE 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	207W00000X	Ophthalmology Physician	45565	FL

General Provider Information

NPI Number	:	1861497638
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY PEARCE M.D.

Provider Business Mailing Address
First Line	:	211 US HIGHWAY 27 S
Second Line	:
City	:	LAKE PLACID
State	:	FL
Zip	:	33852-7920
Country	:	US
Telephone Number	:	863-465-1880
Fax Number	:	863-465-6385

Provider Business Practice Location Address
First Line	:	211 US HIGHWAY 27 S
Second Line	:
City	:	LAKE PLACID
State	:	FL
Zip	:	33852-7920
Country	:	US
Telephone Number	:	863-465-1880
Fax Number	:	863-465-6385

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	03/15/2024

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