MEDICARE: DR. BRUCE WAXMAN M.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
1	207X00000X	Orthopaedic Surgery Physician	ME0028598	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790706232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE WAXMAN M.D.

Provider Business Mailing Address
First Line	:	4398 HICKORY DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3906
Country	:	US
Telephone Number	:	561-312-7004
Fax Number	:

Provider Business Practice Location Address
First Line	:	4398 HICKORY DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3906
Country	:	US
Telephone Number	:	561-312-7004
Fax Number	:

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	10/03/2012

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