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NPI Code Detail

MEDICARE: LESTER R BAUMGARTEN MS PT ATC CSCS

MEDICARE: LESTER R BAUMGARTEN MS PT ATC CSCS
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
1225100000XPhysical TherapistPT30236FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417336132
Entity Type Code : Individual
Provider Name (Legal Business Name) : LESTER R BAUMGARTEN MS PT ATC CSCS
Provider Business Mailing Address
First Line : 600 OPP DR
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-4493
Country : US
Telephone Number : 850-301-1935
Fax Number : 850-301-1937
Provider Business Practice Location Address
First Line : 600 OPP DR
Second Line :
City : FORT WALTON BEACH
State : FL
Zip : 32548-4493
Country : US
Telephone Number : 850-301-1935
Fax Number : 850-301-1937
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2015
Last Update Date : 05/27/2015

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