MEDICARE: JEFFREY H. GARELICK, MD PA

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	207RG0100X	Gastroenterology Physician	ME0070879	FL

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	:	1184629917
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY H. GARELICK, MD PA

Provider Business Mailing Address
First Line	:	2001 N FLAGLER DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-6109
Country	:	US
Telephone Number	:	561-659-6632
Fax Number	:	561-655-6331

Provider Business Practice Location Address
First Line	:	3370 BURNS RD
Second Line	:	STE 104
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-4327
Country	:	US
Telephone Number	:	561-691-0320
Fax Number	:	561-691-4721

Authorized Official
Title or Position	:	ADMINISTRATIVE DIRECTOR
Name	:	LISA BOLOGNINI
Credential	:
Telephone Number	:	561-659-6632

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	10/21/2010

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