MEDICARE: REEDER MEDICAL GROUP

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	146M00000X	Intermediate Emergency Medical Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1	OTHER	FL	MEDICAL PRACTICE

General Provider Information

NPI Number	:	1154626778
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REEDER MEDICAL GROUP

Provider Business Mailing Address
First Line	:	1400 SOUTH ANDREWS AVENUE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316
Country	:	US
Telephone Number	:	954-764-8911
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 S ANDREWS AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33316-1840
Country	:	US
Telephone Number	:	954-764-8911
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT L REEDER
Credential	:	MD
Telephone Number	:	954-764-8911

Provider Enumeration Date	:	01/12/2011
Last Update Date	:	01/12/2011

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Directions to “REEDER MEDICAL GROUP ” Practice Location

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