MEDICARE: ELIZABETH ANN GUNTHER D.O.

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	207Q00000X	Family Medicine Physician	OS8306	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013099761
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH ANN GUNTHER D.O.

Provider Business Mailing Address
First Line	:	3618 LANTANA RD STE 100
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-2247
Country	:	US
Telephone Number	:	561-318-6158
Fax Number	:	561-328-6918

Provider Business Practice Location Address
First Line	:	3618 LANTANA RD STE 100
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33462-2247
Country	:	US
Telephone Number	:	561-318-6158
Fax Number	:	561-328-6918

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

Provider Enumeration Date	:	10/20/2006
Last Update Date	:	03/02/2020

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