MEDICARE: ROBERT KENNETH HITTEL M.D.

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	207Q00000X	Family Medicine Physician	ME0051043	FL

General Provider Information

NPI Number	:	1396771051
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT KENNETH HITTEL M.D.

Provider Business Mailing Address
First Line	:	491 W PALM VALLEY DR
Second Line	:
City	:	OVIEDO
State	:	FL
Zip	:	32765-9213
Country	:	US
Telephone Number	:	407-366-6459
Fax Number	:

Provider Business Practice Location Address
First Line	:	5810 S SEMORAN BLVD
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32822-4812
Country	:	US
Telephone Number	:	407-207-0601
Fax Number	:

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

Provider Enumeration Date	:	06/24/2006
Last Update Date	:	07/08/2007

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