MEDICARE: BTW MED, LLC

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1063814341
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BTW MED, LLC

Provider Business Mailing Address
First Line	:	2901 SW 149TH AVE
Second Line	:	SUITE 400
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4151
Country	:	US
Telephone Number	:	954-874-4617
Fax Number	:	954-239-3902

Provider Business Practice Location Address
First Line	:	2901 SW 149TH AVE
Second Line	:	SUITE 400
City	:	MIRAMAR
State	:	FL
Zip	:	33027-4151
Country	:	US
Telephone Number	:	954-874-4617
Fax Number	:	954-239-3902

Authorized Official
Title or Position	:	CREEDENTIALING SPECIALIST
Name	:	LYDIA E ARVELO
Credential	:
Telephone Number	:	954-416-1781

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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