MEDICARE: DANIEL BENDETOWICZ 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	207R00000X	Internal Medicine Physician	ME75758	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00141144	OTHER	FL	RAILROAD PROVIDER NUMBER

General Provider Information

NPI Number	:	1891793287
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL BENDETOWICZ MD

Provider Business Mailing Address
First Line	:	6840 INTERNATIONAL CENTER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7161
Country	:	US
Telephone Number	:	239-985-1050
Fax Number	:	239-985-1060

Provider Business Practice Location Address
First Line	:	6840 INTERNATIONAL CENTER BLVD
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33912-7161
Country	:	US
Telephone Number	:	239-985-1050
Fax Number	:	239-985-1060

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

Provider Enumeration Date	:	07/11/2005
Last Update Date	:	03/17/2018

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