MEDICARE: PETER F MERKLE MD

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	207X00000X	Orthopaedic Surgery Physician	ME51275	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	05996	OTHER	FL	BLUE SHIELD

General Provider Information

NPI Number	:	1710993258
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER F MERKLE MD

Provider Business Mailing Address
First Line	:	1101 E SAMPLE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5113
Country	:	US
Telephone Number	:	954-783-7100
Fax Number	:	954-783-7304

Provider Business Practice Location Address
First Line	:	1101 E SAMPLE RD
Second Line	:
City	:	POMPANO BEACH
State	:	FL
Zip	:	33064-5104
Country	:	US
Telephone Number	:	954-783-7100
Fax Number	:	954-783-7304

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	02/27/2008

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Directions to “ PETER F MERKLE MD” Practice Location

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