MEDICARE: GERTRUDE PAUL

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	3747P1801X	Personal Care Attendant

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

General Provider Information

NPI Number	:	1538514013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GERTRUDE PAUL

Provider Business Mailing Address
First Line	:	12344 HOLLY JANE CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-5841
Country	:	US
Telephone Number	:	407-350-8362
Fax Number	:

Provider Business Practice Location Address
First Line	:	12344 HOLLY JANE CT
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32824-5841
Country	:	US
Telephone Number	:	407-350-8362
Fax Number	:

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

Provider Enumeration Date	:	05/03/2016
Last Update Date	:	05/03/2016

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Directions to “ GERTRUDE PAUL ” Practice Location

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