MEDICARE: DR. DALTON REMELL CARPENTER 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	ME135694	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	:	1982638045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DALTON REMELL CARPENTER MD

Provider Business Mailing Address
First Line	:	700 8TH AVE W STE 101
Second Line	:
City	:	PALMETTO
State	:	FL
Zip	:	34221-4737
Country	:	US
Telephone Number	:	941-776-4008
Fax Number	:	941-845-4963

Provider Business Practice Location Address
First Line	:	300 RIVERSIDE DR E STE 1500
Second Line	:
City	:	BRADENTON
State	:	FL
Zip	:	34208-1031
Country	:	US
Telephone Number	:	941-741-3338
Fax Number	:	941-714-7484

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

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	01/02/2019

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