MEDICARE: DR. ROBERT F METNICK DPM

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	213E00000X	Podiatrist	PO2235	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45440	OTHER	FL	BCBS GROUP ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	480027518	OTHER	FL	RAILROAD INDIVIDUAL ID
5	DE7435	OTHER	FL	RAILROAD GROUP ID
6	650859164	OTHER	FL	TAX ID
7	65246	OTHER	FL	BCBS INDIVIDUAL ID
8	PO2235	OTHER	FL	MEDICAL LICENSE
9	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366441347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT F METNICK DPM

Provider Business Mailing Address
First Line	:	422 APPALOOSA RD
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688-9060
Country	:	US
Telephone Number	:	727-455-4108
Fax Number	:	727-669-8417

Provider Business Practice Location Address
First Line	:	422 APPALOOSA RD
Second Line	:
City	:	TARPON SPRINGS
State	:	FL
Zip	:	34688
Country	:	US
Telephone Number	:	727-455-4108
Fax Number	:	727-669-8417

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

Provider Enumeration Date	:	07/20/2005
Last Update Date	:	05/21/2024

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Directions to “ DR. ROBERT F METNICK DPM” Practice Location

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