MEDICARE: WHEELCHAIR DOCTOR, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	1852	FL

General Provider Information

NPI Number	:	1568613248
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHEELCHAIR DOCTOR, INC.

Provider Business Mailing Address
First Line	:	1911 W COPANS RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-1517
Country	:	US
Telephone Number	:	954-979-7781
Fax Number	:	954-979-7781

Provider Business Practice Location Address
First Line	:	1911 W COPANS RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-1517
Country	:	US
Telephone Number	:	954-979-7781
Fax Number	:	954-979-7781

Authorized Official
Title or Position	:	CORP SECRETARY
Name	:	SANDRA RUTH HARADON
Credential	:
Telephone Number	:	954-979-7781

Provider Enumeration Date	:	10/01/2008
Last Update Date	:	10/01/2008

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