MEDICARE: SEAN GARLAND MSACN

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	133N00000X	Nutritionist

General Provider Information

NPI Number	:	1255824678
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEAN GARLAND MSACN

Provider Business Mailing Address
First Line	:	616 CLEARWATER PARK RD APT 1201
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-6250
Country	:	US
Telephone Number	:	315-243-4234
Fax Number	:

Provider Business Practice Location Address
First Line	:	3370 GRANDE CORNICHE
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-1613
Country	:	US
Telephone Number	:	561-630-0333
Fax Number	:

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

Provider Enumeration Date	:	06/11/2018
Last Update Date	:	06/11/2018

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