MEDICARE: DR.ROBERT TEITELBAUM

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	332B00000X	Durable Medical Equipment & Medical Supplies	PO 1400	FL

General Provider Information

NPI Number	:	1184892630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR.ROBERT TEITELBAUM

Provider Business Mailing Address
First Line	:	4763 TAMIAMI TRL N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-3006
Country	:	US
Telephone Number	:	239-263-4595
Fax Number	:	239-263-8851

Provider Business Practice Location Address
First Line	:	4763 TAMIAMI TRL N
Second Line	:
City	:	NAPLES
State	:	FL
Zip	:	34103-3006
Country	:	US
Telephone Number	:	239-263-4595
Fax Number	:	239-263-8851

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROBERT D. TEITELBAUM
Credential	:	D.P.M.
Telephone Number	:	239-263-4595

Provider Enumeration Date	:	02/19/2008
Last Update Date	:	02/19/2008

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Directions to “DR.ROBERT TEITELBAUM ” Practice Location

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