MEDICARE: DR. MAXWELL SOBEL 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	2084P0800X	Psychiatry Physician	ME76528	FL

General Provider Information

NPI Number	:	1558311621
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAXWELL SOBEL M.D.

Provider Business Mailing Address
First Line	:	5506 SPECTACULAR BID DR
Second Line	:
City	:	WESLEY CHAPEL
State	:	FL
Zip	:	33544-5575
Country	:	US
Telephone Number	:	813-973-7676
Fax Number	:

Provider Business Practice Location Address
First Line	:	12734 KENWOOD LN
Second Line	:	SUITE 84
City	:	FT MYERS
State	:	FL
Zip	:	33907-5666
Country	:	US
Telephone Number	:	239-936-5250
Fax Number	:	239-936-9970

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	07/08/2007

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