MEDICARE: ROBERT A OESTERLE MD

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	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	ME0067870	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

General Provider Information

NPI Number	:	1053524116
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT A OESTERLE MD

Provider Business Mailing Address
First Line	:	300 HEALTH PARK BLVD.
Second Line	:	SUITE 3008
City	:	ST. AUGUSTINE
State	:	FL
Zip	:	32086-3703
Country	:	US
Telephone Number	:	904-810-2425
Fax Number	:	904-810-5321

Provider Business Practice Location Address
First Line	:	300 HEALTH PARK BLVD.
Second Line	:	SUITE 3008
City	:	ST. AUGUSTINE
State	:	FL
Zip	:	32086-3703
Country	:	US
Telephone Number	:	904-810-2425
Fax Number	:	904-810-5321

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	05/30/2012

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