MEDICARE: NETWORK TPA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	204E00000X	Oral & Maxillofacial Surgery (D.M.D.)
2	207L00000X	Anesthesiology Physician
3	207N00000X	Dermatology Physician
4	207Q00000X	Family Medicine Physician
5	207T00000X	Neurological Surgery Physician
6	207V00000X	Obstetrics & Gynecology Physician
7	207W00000X	Ophthalmology Physician
8	207X00000X	Orthopaedic Surgery Physician
9	207Y00000X	Otolaryngology Physician
10	208000000X	Pediatrics Physician
11	208100000X	Physical Medicine & Rehabilitation Physician
12	2085R0202X	Diagnostic Radiology Physician
13	208800000X	Urology Physician
14	208D00000X	General Practice Physician
15	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1609015866
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NETWORK TPA, LLC

Provider Business Mailing Address
First Line	:	3114 COMMERCE PKWY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3943
Country	:	US
Telephone Number	:	954-331-6500
Fax Number	:	954-331-6699

Provider Business Practice Location Address
First Line	:	3114 COMMERCE PKWY
Second Line	:
City	:	MIRAMAR
State	:	FL
Zip	:	33025-3943
Country	:	US
Telephone Number	:	954-331-6500
Fax Number	:	954-331-6699

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	MR. KEN NEDD
Credential	:
Telephone Number	:	954-331-6500

Provider Enumeration Date	:	02/11/2009
Last Update Date	:	02/11/2009

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