MEDICARE: GREGORY ASLANIAN MD

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	ME39528	FL

General Provider Information

NPI Number	:	1023064342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY ASLANIAN MD

Provider Business Mailing Address
First Line	:	5700 LAKE WORTH RD
Second Line	:	#204
City	:	LAKE WORTH
State	:	FL
Zip	:	33463
Country	:	US
Telephone Number	:	561-968-7968
Fax Number	:	561-964-4603

Provider Business Practice Location Address
First Line	:	10075 S JOG RD
Second Line	:	STE 300
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33437-3535
Country	:	US
Telephone Number	:	561-737-9227
Fax Number	:	561-737-8581

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

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	04/20/2012

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