MEDICARE: FRED E AUBERT JR. M.D.

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	2084N0400X	Neurology Physician	ME96433	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	56335	OTHER	FL	BCBSFL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952307878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRED E AUBERT JR. M.D.

Provider Business Mailing Address
First Line	:	1106 HOSPITAL RD
Second Line	:	NEUROSCIENCE CENTER
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-6742
Country	:	US
Telephone Number	:	850-863-8169
Fax Number	:	850-863-7045

Provider Business Practice Location Address
First Line	:	1106 HOSPITAL RD
Second Line	:	NEUROSCIENCE CENTER
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-6742
Country	:	US
Telephone Number	:	850-863-8169
Fax Number	:	850-863-7045

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

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	01/16/2017

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