MEDICARE: SUMMIT MEDICAL SOULTIONS

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1477867018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT MEDICAL SOULTIONS

Provider Business Mailing Address
First Line	:	8608 PALISADES LAKES DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-6331
Country	:	US
Telephone Number	:	561-707-8927
Fax Number	:

Provider Business Practice Location Address
First Line	:	8608 PALISADES LAKES DR
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33411-6331
Country	:	US
Telephone Number	:	561-707-8927
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. RANDALL G NOAKES
Credential	:
Telephone Number	:	561-707-8927

Provider Enumeration Date	:	08/05/2010
Last Update Date	:	08/05/2010

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