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NPI Code Detail

MEDICARE: MICHAEL GARTNER PA-C

MEDICARE: MICHAEL GARTNER PA-C
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
1363A00000XPhysician AssistantPA9101158FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2E6648OTHERFLMEDICARE CORE

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 : 1487643110
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL GARTNER PA-C
Provider Business Mailing Address
First Line : 1403 TIBURON CT
Second Line :
City : RIVIERA BEACH
State : FL
Zip : 33404-1800
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 200 NW 7TH AVE
Second Line : PHOENIX EMERGENCY MEDICINE OF BROWARD, LLC
City : FORT LAUDERDALE
State : FL
Zip : 33311-9026
Country : US
Telephone Number : 954-759-6793
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2005
Last Update Date : 05/14/2008

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Directions to “ MICHAEL GARTNER PA-C” Practice Location

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