MEDICARE: PATRICIA MARY VELTMAN LDO

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	156FX1800X	Optician	DO4422	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	:	1932369147
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA MARY VELTMAN LDO

Provider Business Mailing Address
First Line	:	1661 SE US HIGHWAY 19
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4830
Country	:	US
Telephone Number	:	352-563-1666
Fax Number	:	352-563-1673

Provider Business Practice Location Address
First Line	:	1661 SE US HIGHWAY 19
Second Line	:
City	:	CRYSTAL RIVER
State	:	FL
Zip	:	34429-4830
Country	:	US
Telephone Number	:	352-563-1666
Fax Number	:	352-563-1673

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

Provider Enumeration Date	:	06/11/2008
Last Update Date	:	06/11/2008

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