MEDICARE: ROBERT PEARSON BEWLEY D.P.M.

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	213E00000X	Podiatrist	PO693	FL

General Provider Information

NPI Number	:	1588689749
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT PEARSON BEWLEY D.P.M.

Provider Business Mailing Address
First Line	:	25921 SAN RAFAEL CT
Second Line	:
City	:	HOWEY IN THE HILLS
State	:	FL
Zip	:	34737-5002
Country	:	US
Telephone Number	:	352-409-1968
Fax Number	:

Provider Business Practice Location Address
First Line	:	25921 SAN RAFAEL CT
Second Line	:
City	:	HOWEY IN THE HILLS
State	:	FL
Zip	:	34737-5002
Country	:	US
Telephone Number	:	352-409-1968
Fax Number	:

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

Provider Enumeration Date	:	07/12/2006
Last Update Date	:	03/10/2011

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