MEDICARE: ROBERT K HALL DPM PA

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	213EP1101X	Primary Podiatric Medicine Podiatrist	PO845	FL

General Provider Information

NPI Number	:	1629375290
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT K HALL DPM PA

Provider Business Mailing Address
First Line	:	1211 E BROWARD BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2129
Country	:	US
Telephone Number	:	954-467-8554
Fax Number	:	954-467-0119

Provider Business Practice Location Address
First Line	:	1211 EAST BROWARD BLVD
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33301-2129
Country	:	US
Telephone Number	:	954-467-8554
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT K HALL
Credential	:	DPM
Telephone Number	:	954-467-8554

Provider Enumeration Date	:	02/17/2011
Last Update Date	:	02/17/2011

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