MEDICARE: ALAN SCOTT DEJARNETTE 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	207R00000X	Internal Medicine Physician	FLME37486	FL

General Provider Information

NPI Number	:	1033156724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN SCOTT DEJARNETTE MD

Provider Business Mailing Address
First Line	:	2700 NE 14TH STREET CSWY
Second Line	:	SUITE 103
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3561
Country	:	US
Telephone Number	:	954-942-8177
Fax Number	:	954-942-1819

Provider Business Practice Location Address
First Line	:	2700 NE 14TH STREET CSWY
Second Line	:	SUITE 103
City	:	POMPANO BEACH
State	:	FL
Zip	:	33062-3561
Country	:	US
Telephone Number	:	954-942-8177
Fax Number	:	954-942-1819

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

Provider Enumeration Date	:	06/01/2006
Last Update Date	:	06/27/2012

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