MEDICARE: TRAIL MEDICAL CENTER 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	207R00000X	Internal Medicine Physician	ME57660	FL

General Provider Information

NPI Number	:	1346555802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRAIL MEDICAL CENTER PA

Provider Business Mailing Address
First Line	:	1266 N MILITARY TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6015
Country	:	US
Telephone Number	:	561-687-8685
Fax Number	:	561-683-2279

Provider Business Practice Location Address
First Line	:	1266 N MILITARY TRL
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33409-6015
Country	:	US
Telephone Number	:	561-687-8685
Fax Number	:	561-683-2279

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. GERARD JEAN-BAPTISTE
Credential	:	M.D
Telephone Number	:	561-687-8685

Provider Enumeration Date	:	08/09/2010
Last Update Date	:	08/09/2010

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