MEDICARE: M E PARKER, INC

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	174400000X	Specialist	SA 4490	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	SA 4490	OTHER	FL	DEPARTMENT OF HEALTH

General Provider Information

NPI Number	:	1003016593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	M E PARKER, INC

Provider Business Mailing Address
First Line	:	13295 SW 72ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3215
Country	:	US
Telephone Number	:	305-388-5009
Fax Number	:

Provider Business Practice Location Address
First Line	:	13295 SW 72ND TER
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33183-3215
Country	:	US
Telephone Number	:	305-388-5009
Fax Number	:

Authorized Official
Title or Position	:	PRESEIDENT
Name	:	MARIA E PARKER
Credential	:	SPEECH PATHOLOGIST
Telephone Number	:	305-388-5009

Provider Enumeration Date	:	07/23/2007
Last Update Date	:	07/23/2007

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Directions to “M E PARKER, INC ” Practice Location

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