MEDICARE: DOC TO YOUR DOOR 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	207Q00000X	Family Medicine Physician	OS9716	FL

General Provider Information

NPI Number	:	1346551363
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOC TO YOUR DOOR PA

Provider Business Mailing Address
First Line	:	101 KEY HAVEN RD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-6221
Country	:	US
Telephone Number	:	305-890-6425
Fax Number	:	888-380-6597

Provider Business Practice Location Address
First Line	:	101 KEY HAVEN RD
Second Line	:
City	:	KEY WEST
State	:	FL
Zip	:	33040-6221
Country	:	US
Telephone Number	:	305-890-6425
Fax Number	:	888-380-6597

Authorized Official
Title or Position	:	DR
Name	:	DR. MATTHEW THOMAS REID
Credential	:	DO
Telephone Number	:	305-890-6425

Provider Enumeration Date	:	06/24/2010
Last Update Date	:	07/07/2010

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