MEDICARE: DR. ROBERT PHILIP LUBERTO DO

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	207QS0010X	Sports Medicine (Family Medicine) Physician	3176	AZ

General Provider Information

NPI Number	:	1760441174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT PHILIP LUBERTO DO

Provider Business Mailing Address
First Line	:	7717 W DEER VALLEY RD
Second Line	:	SUITE 125
City	:	PEORIA
State	:	AZ
Zip	:	85382
Country	:	US
Telephone Number	:	623-561-6300
Fax Number	:	623-572-5400

Provider Business Practice Location Address
First Line	:	7717 W. DEER VALLEY RD.
Second Line	:	SUITE 125
City	:	PEORIA
State	:	AZ
Zip	:	85382
Country	:	US
Telephone Number	:	623-561-6300
Fax Number	:	623-572-5400

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

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	07/05/2011

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