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General NPI Number Information
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NPI Number | 1467722025
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Entity Type | Organization
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Legal Business Name | FIRST COAST ENDOCRINOLOGY, P.A.
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 06/04/2012
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Provider Practice Location Address
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Address Line | 300 HEALTH PARK BLVD SUITE 3008
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3707
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Country | US
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Telephone | 904-810-2425
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Fax | 904-810-5321
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Provider Business Mailing Address
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Address Line | 300 HEALTH PARK BLVD SUITE 3008
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City | ST AUGUSTINE
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State | FL
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Zip | 32086-3707
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Country | US
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Telephone | 904-810-2425
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Fax | 904-810-5321
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Authorized Official
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Title or Position | OWNER
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Name | MR. ROBERT ANDREW OESTERLE
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Credential | M.D.
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Telephone | 904-810-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | ME0067670
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME0067870
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License Number State | FL
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