MEDICARE: DR. ROBERT BERNIE PRITT D.O.

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	OS6816	FL

General Provider Information

NPI Number	:	1568424729
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT BERNIE PRITT D.O.

Provider Business Mailing Address
First Line	:	13670 METROPOLIS AVE
Second Line	:	SUITE 104
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4346
Country	:	US
Telephone Number	:	239-489-0800
Fax Number	:	239-489-3274

Provider Business Practice Location Address
First Line	:	13670 METROPOLIS AVE
Second Line	:	SUITE 104
City	:	FORT MYERS
State	:	FL
Zip	:	33912-4346
Country	:	US
Telephone Number	:	239-489-0800
Fax Number	:	239-489-3274

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	07/18/2008

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