MEDICARE: DR. GENE NEYTMAN DO

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
1	207R00000X	Internal Medicine Physician	OS8861	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003845801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GENE NEYTMAN DO

Provider Business Mailing Address
First Line	:	1674 MERIDIAN AVE
Second Line	:	SUITE 201
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2801
Country	:	US
Telephone Number	:	305-760-8756
Fax Number	:	305-760-8759

Provider Business Practice Location Address
First Line	:	1674 MERIDIAN AVE
Second Line	:	SUITE 201
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2801
Country	:	US
Telephone Number	:	305-760-8756
Fax Number	:	305-760-8759

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	03/17/2016

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