MEDICARE: SCOTT A. GARTNER, OD, PA

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	152WL0500X	Low Vision Rehabilitation Optometrist	OPC1411	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	:	1831365832
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT A. GARTNER, OD, PA

Provider Business Mailing Address
First Line	:	5944 CORAL RIDGE DR
Second Line	:	STE 210
City	:	CORAL SPRINGS
State	:	FL
Zip	:	33076-3300
Country	:	US
Telephone Number	:	954-557-5913
Fax Number	:

Provider Business Practice Location Address
First Line	:	7101 FAIRWAY DR
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33418-3701
Country	:	US
Telephone Number	:	954-557-5913
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SCOTT ALAN GARTNER
Credential	:	OD
Telephone Number	:	954-557-5913

Provider Enumeration Date	:	04/30/2008
Last Update Date	:	06/01/2010

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