MEDICARE: DR. SAMMY ARNOLD GAMMENTHALER MD

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	207RC0000X	Cardiovascular Disease Physician	38340	NC
2	207RC0000X	Cardiovascular Disease Physician	ME108483	FL
3	207RC0000X	Cardiovascular Disease Physician	063196	GA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	14H8K	OTHER	FL	BCBS OF FL
5	127F2	OTHER	NC	BCBS NC INDIVIDUAL ID #

General Provider Information

NPI Number	:	1396747424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SAMMY ARNOLD GAMMENTHALER MD

Provider Business Mailing Address
First Line	:	PO BOX 1289
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-1289
Country	:	US
Telephone Number	:	352-343-1158
Fax Number	:	352-343-8106

Provider Business Practice Location Address
First Line	:	1815 SALK AVE
Second Line	:
City	:	TAVARES
State	:	FL
Zip	:	32778-4311
Country	:	US
Telephone Number	:	352-343-1158
Fax Number	:	352-343-8106

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/19/2015

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Directions to “ DR. SAMMY ARNOLD GAMMENTHALER MD” Practice Location

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