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General NPI Number Information
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NPI Number | 1497715569
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Entity Type | Individual
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Provider Name | ROBERT NATHAN FEDORE DC
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 2339 N MONROE ST
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City | TALLAHASSEE
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State | FL
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Zip | 32303-4733
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Country | US
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Telephone | 850-900-3451
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Fax |
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Provider Business Mailing Address
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Address Line | 3758 LAUREL TRACE WAY
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City | TALLAHASSEE
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State | FL
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Zip | 32303-1516
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Country | US
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Telephone | 724-396-1585
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8901
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License Number State | FL
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