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NPI Code Detail

MEDICARE: DR. ROBERT L. MAIELLO M.D.

MEDICARE: DR. ROBERT L. MAIELLO 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
1208100000XPhysical Medicine & Rehabilitation PhysicianME60568FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1593656451OTHERFLUNITEDHEALTHCARE
212890OTHERFLBLUE CROSS BLUE SHEILD
35700283OTHERFLAETNA
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5250011577OTHERFLPALMETTO GBA RAILROAD MCR
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073516811
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT L. MAIELLO M.D.
Provider Business Mailing Address
First Line : PO BOX 223730
Second Line :
City : GAINESVILLE
State : FL
Zip : 32611-0001
Country : US
Telephone Number : 352-273-9860
Fax Number : 352-294-8035
Provider Business Practice Location Address
First Line : 600 E DIXIE AVE
Second Line :
City : LEESBURG
State : FL
Zip : 34748-5925
Country : US
Telephone Number : 352-273-9860
Fax Number : 352-294-8035
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 03/17/2022

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