Healthcare Provider Details

I. General information

NPI: 1649027996
Provider Name (Legal Business Name): ROBERTO LEON FELIPE LOBELO MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: FELIPE LOBELO MD, PHD

II. Dates (important events)

Enumeration Date: 05/03/2024
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1341 WOODLAND HILLS DR NE
ATLANTA GA
30324-4625
US

IV. Provider business mailing address

1341 WOODLAND HILLS DR NE
ATLANTA GA
30324-4625
US

V. Phone/Fax

Practice location:
  • Phone: 404-307-4027
  • Fax:
Mailing address:
  • Phone: 404-307-4027
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: