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NPI Code Detail

MEDICARE: DR. REBECCA A PROSTKO M.D.

MEDICARE: DR. REBECCA A PROSTKO 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
1207R00000XInternal Medicine PhysicianME0052247FL

General Provider Information

NPI Number : 1437124914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. REBECCA A PROSTKO M.D.
Provider Business Mailing Address
First Line : 938 SW MARTIN DOWNS BLVD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2816
Country : US
Telephone Number : 772-223-6410
Fax Number : 772-223-0092
Provider Business Practice Location Address
First Line : 938 SW MARTIN DOWNS BLVD
Second Line :
City : PALM CITY
State : FL
Zip : 34990-2816
Country : US
Telephone Number : 772-223-6410
Fax Number : 772-223-0092
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 07/08/2007

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Directions to “ DR. REBECCA A PROSTKO M.D.” Practice Location

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