MEDICARE: ANTHONY MCLEAN

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

General Provider Information

NPI Number	:	1598157893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY MCLEAN

Provider Business Mailing Address
First Line	:	3700 GALT OCEAN DR
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-7655
Country	:	US
Telephone Number	:	516-304-6448
Fax Number	:

Provider Business Practice Location Address
First Line	:	3700 GALT OCEAN DR APT 1509
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-7637
Country	:	US
Telephone Number	:	516-304-6448
Fax Number	:

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

Provider Enumeration Date	:	02/23/2015
Last Update Date	:	04/01/2015

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