MEDICARE: MR. ROBERT S FORTUNATO RRT

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	2278H0200X	Home Health Certified Respiratory Therapist	RT0000797	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

General Provider Information

NPI Number	:	1972665677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT S FORTUNATO RRT

Provider Business Mailing Address
First Line	:	404 MIRAMAR LN
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2159
Country	:	US
Telephone Number	:	561-906-1889
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 MIRAMAR LN
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-2159
Country	:	US
Telephone Number	:	561-906-1889
Fax Number	:

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

Provider Enumeration Date	:	12/16/2006
Last Update Date	:	07/08/2007

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