=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336425065
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROBERT A MCCARRON M.D.P.A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/26/2011
-----------------------------------------------------
Last Update Date | 10/26/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 505 BEACHLAND BLVD PMB217
-----------------------------------------------------
City | VERO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32963-1710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-569-7999
-----------------------------------------------------
Fax | 772-569-7799
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 BEACHLAND BLVD PMB217
-----------------------------------------------------
City | VERO BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32963-1710
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 772-569-7999
-----------------------------------------------------
Fax | 772-569-7799
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | DR. ROBERT ANDREW MCCARRON
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 772-569-7999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number | ME80972
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------