MEDICARE: DR. ROBERT CARITHERS 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	208000000X	Pediatrics Physician	ME0048110	FL

General Provider Information

NPI Number	:	1255395778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT CARITHERS MD

Provider Business Mailing Address
First Line	:	605 S ORANGE ST
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7320
Country	:	US
Telephone Number	:	386-427-4882
Fax Number	:	386-426-1260

Provider Business Practice Location Address
First Line	:	605 S ORANGE ST
Second Line	:
City	:	NEW SMYRNA BEACH
State	:	FL
Zip	:	32168-7320
Country	:	US
Telephone Number	:	386-427-4882
Fax Number	:	386-426-1260

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	07/09/2007

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