Healthcare Provider Details

I. General information

NPI: 1437128675
Provider Name (Legal Business Name): ROBERT J. TRENSCHEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15858 S.W. WARFIELD BLVD. BOX 457
INDIANTOWN FL
34956-0457
US

IV. Provider business mailing address

4450 S TIFFANY DR
WEST PALM BEACH FL
33407-3241
US

V. Phone/Fax

Practice location:
  • Phone: 772-597-3596
  • Fax: 772-597-4194
Mailing address:
  • Phone: 561-844-9443
  • Fax: 561-844-1013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS5903
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: