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NPI Code Detail

MEDICARE: MR. WAYNE P TEPPER O.D.

MEDICARE: MR. WAYNE P TEPPER O.D.
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
1152W00000XOptometristOPC1118FL

General Provider Information

NPI Number : 1558430728
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. WAYNE P TEPPER O.D.
Provider Business Mailing Address
First Line : 333 PLAZA REAL
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-3938
Country : US
Telephone Number : 561-392-8383
Fax Number : 561-392-1134
Provider Business Practice Location Address
First Line : 333 PLAZA REAL
Second Line :
City : BOCA RATON
State : FL
Zip : 33432-3938
Country : US
Telephone Number : 561-392-8383
Fax Number : 561-392-1134
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2006
Last Update Date : 07/08/2007

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Directions to “ MR. WAYNE P TEPPER O.D.” Practice Location

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