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NPI Code Detail

MEDICARE: DR. RONALD BARRY FAUER M.D.

MEDICARE: DR. RONALD BARRY FAUER 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
1204C00000XSports Medicine (Neuromusculoskeletal Medicine) PhysicianME32413FL
2208800000XUrology PhysicianME0032413FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P00731865OTHERFLRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000056842, XOTHERFLHUMANA
24069055OTHERFLAETNA
32529OTHERFLDIMENSIONS
5P0003142OTHERFLFLORIDA HEALTHCARE PLUS
6002529OTHERFLNEIGHBORHOOD HEALTH PARTNERSHIP
7205812OTHERFLAVMED
893504OTHERFLBCBS OF FL
9MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
100925624OTHERFLCIGNA
1111984OTHERFLMEDICA

General Provider Information

NPI Number : 1437143187
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD BARRY FAUER M.D.
Provider Business Mailing Address
First Line : 2234 COLONIAL BLVD
Second Line : MANAGED CARE DEPT
City : FORT MYERS
State : FL
Zip : 33907-1412
Country : US
Telephone Number : 239-931-7342
Fax Number : 239-931-7385
Provider Business Practice Location Address
First Line : 1200 E BROWARD BLVD
Second Line :
City : FORT LAUDERDALE
State : FL
Zip : 33301-2134
Country : US
Telephone Number : 954-463-6408
Fax Number : 954-463-1858
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 10/15/2012

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