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General NPI Number Information
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NPI Number | 1912079807
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Entity Type | Individual
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Provider Name | GAETANO J SCUDERI M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2055 MILITARY TRAIL STE 204
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-747-9334
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Fax | 561-747-9633
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Provider Business Mailing Address
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Address Line | 2055 MILITARY TRAIL STE 204
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City | JUPITER
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State | FL
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Zip | 33458
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Country | US
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Telephone | 561-747-9334
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Fax | 561-747-9633
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | ME64034
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License Number State | FL
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