MEDICARE: HAROLD M. REHBEIN, M.D., P.A.

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	207N00000X	Dermatology Physician	ME0017350	FL

General Provider Information

NPI Number	:	1376527937
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAROLD M. REHBEIN, M.D., P.A.

Provider Business Mailing Address
First Line	:	5757 BOOTH RD
Second Line	:	#200
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5980
Country	:	US
Telephone Number	:	904-730-0078
Fax Number	:	904-730-0322

Provider Business Practice Location Address
First Line	:	5757 BOOTH RD
Second Line	:	#200
City	:	JACKSONVILLE
State	:	FL
Zip	:	32207-5980
Country	:	US
Telephone Number	:	904-730-0078
Fax Number	:	904-730-0322

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. HAROLD M REHBEIN
Credential	:	M.D.
Telephone Number	:	904-730-0078

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	10/04/2007

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