MEDICARE: FLORIDA FERTILITY INSTITUTE PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207VE0102X	Reproductive Endocrinology Physician
2	207VF0040X	Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
3	207VG0400X	Gynecology Physician
4	363LX0001X	Obstetrics & Gynecology Nurse Practitioner
5	363LA2200X	Adult Health Nurse Practitioner
6	363LX0106X	Occupational Health Nurse Practitioner
7	174400000X	Specialist

General Provider Information

NPI Number	:	1821215120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FLORIDA FERTILITY INSTITUTE PA

Provider Business Mailing Address
First Line	:	2454 N MCMULLEN BOOTH RD
Second Line	:	SUITE 601
City	:	CLEARWATER
State	:	FL
Zip	:	33759-1353
Country	:	US
Telephone Number	:	727-796-7705
Fax Number	:	727-796-8764

Provider Business Practice Location Address
First Line	:	2454 N MCMULLEN BOOTH RD
Second Line	:	SUITE 601
City	:	CLEARWATER
State	:	FL
Zip	:	33759-1353
Country	:	US
Telephone Number	:	727-796-7705
Fax Number	:	727-796-8764

Authorized Official
Title or Position	:	PRACTICE ADMINISTRATOR
Name	:	NANCY STEIN
Credential	:
Telephone Number	:	727-669-3403

Provider Enumeration Date	:	04/19/2007
Last Update Date	:	07/22/2016

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Practice Location Address:

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Practice Location Address:

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Practice Fax:

1093867012 — DR. MICHELLE SCARGLE MD
Practice Location Address:

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Directions to “FLORIDA FERTILITY INSTITUTE PA ” Practice Location

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