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General NPI Number Information
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NPI Number | 1619962909
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Entity Type | Individual
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Provider Name | DAVID TEITELBAUM MD
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Gender | Male
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Dates
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Enumeration Date | 09/13/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 EXECUTIVE DR SUITE 3
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City | OVIEDO
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State | FL
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Zip | 32765-8140
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Country | US
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Telephone | 407-365-2929
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Fax | 407-365-8518
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Provider Business Mailing Address
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Address Line | 1000 EXECUTIVE DR SUITE 3
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City | OVIEDO
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State | FL
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Zip | 32765-8140
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Country | US
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Telephone | 407-365-2929
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Fax | 407-365-8518
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | ME 42346
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License Number State | FL
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