MEDICARE: PETER ROME BENDETSON MD

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	174400000X	Specialist	ME38840	FL

General Provider Information

NPI Number	:	1811956329
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER ROME BENDETSON MD

Provider Business Mailing Address
First Line	:	1180 BEACON ST STE 3A
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3806
Country	:	US
Telephone Number	:	617-566-3123
Fax Number	:	617-739-1231

Provider Business Practice Location Address
First Line	:	1180 BEACON STREET, SUITE 3A
Second Line	:
City	:	BROOKLINE
State	:	MA
Zip	:	02446-3806
Country	:	US
Telephone Number	:	617-566-3123
Fax Number	:	617-739-1231

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

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	01/15/2013

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Directions to “ PETER ROME BENDETSON MD” Practice Location

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