MEDICARE: GEORGY KASPAR

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	TRN16758	FL

General Provider Information

NPI Number	:	1407138654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGY KASPAR

Provider Business Mailing Address
First Line	:	3633 E SANDPIPER DR
Second Line	:	APT#8
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-2464
Country	:	US
Telephone Number	:	561-309-9075
Fax Number	:

Provider Business Practice Location Address
First Line	:	3633 E SANDPIPER DR
Second Line	:	APT#8
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33436-2464
Country	:	US
Telephone Number	:	561-309-9075
Fax Number	:

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

Provider Enumeration Date	:	09/14/2011
Last Update Date	:	09/14/2011

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Directions to “ GEORGY KASPAR ” Practice Location

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