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NPI Code Detail

MEDICARE: MR. DEXTER DAVID BUELOW RRT

MEDICARE: MR. DEXTER DAVID BUELOW RRT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1227900000XRegistered Respiratory Therapist74995TX
2227900000XRegistered Respiratory TherapistRT10416FL

General Provider Information

NPI Number : 1003192931
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DEXTER DAVID BUELOW RRT
Provider Business Mailing Address
First Line : 4341 AVIAN AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-7836
Country : US
Telephone Number : 239-220-7369
Fax Number :
Provider Business Practice Location Address
First Line : 4341 AVIAN AVE
Second Line :
City : FORT MYERS
State : FL
Zip : 33916-7836
Country : US
Telephone Number : 239-220-7369
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2011
Last Update Date : 10/24/2011

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