=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346555661
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THOMAS FEISTMANN MD PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2010
-----------------------------------------------------
Last Update Date | 08/11/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5405 OKEECHOBEE BLVD SUITE 306
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33417-4543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-683-8700
-----------------------------------------------------
Fax | 561-683-1925
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5405 OKEECHOBEE BLVD SUITE 306
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33417-4543
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-683-8700
-----------------------------------------------------
Fax | 561-683-1925
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | THOMAS FEISTMANN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 561-683-8700
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RC0000X
-----------------------------------------------------
Taxonomy Name | Cardiovascular Disease Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------