MEDICARE: SAMUEL SCARDINOO.D.,P.A.

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	152W00000X	Optometrist

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	:	1033377593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL SCARDINOO.D.,P.A.

Provider Business Mailing Address
First Line	:	2830 N HIAWASSEE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3319
Country	:	US
Telephone Number	:	407-296-2020
Fax Number	:	407-294-0074

Provider Business Practice Location Address
First Line	:	2830 N HIAWASSEE RD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32818-3319
Country	:	US
Telephone Number	:	407-296-2020
Fax Number	:	407-294-0074

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. SAMUEL SCARDINO
Credential	:	O.D.
Telephone Number	:	407-296-2020

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	05/30/2008

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