Healthcare Provider Details

I. General information

NPI: 1831365832
Provider Name (Legal Business Name): SCOTT A. GARTNER, OD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2008
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 FAIRWAY DR
PALM BEACH GARDENS FL
33418-3701
US

IV. Provider business mailing address

5944 CORAL RIDGE DR STE 210
CORAL SPRINGS FL
33076-3300
US

V. Phone/Fax

Practice location:
  • Phone: 954-557-5913
  • Fax:
Mailing address:
  • Phone: 954-557-5913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License NumberOPC1411
License Number StateFL

VIII. Authorized Official

Name: DR. SCOTT ALAN GARTNER
Title or Position: PRESIDENT
Credential: OD
Phone: 954-557-5913