MEDICARE: DR. ROBERT DREW IVER D.D.S.

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	1223G0001X	General Practice Dentistry	5929	FL

General Provider Information

NPI Number	:	1992039457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT DREW IVER D.D.S.

Provider Business Mailing Address
First Line	:	1205 LINCOLN ROAD
Second Line	:	SUITE #207
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2365
Country	:	US
Telephone Number	:	305-672-8894
Fax Number	:	305-538-8616

Provider Business Practice Location Address
First Line	:	1205 LINCOLN ROAD
Second Line	:	SUITE #207
City	:	MIAMI BEACH
State	:	FL
Zip	:	33139-2365
Country	:	US
Telephone Number	:	305-672-8894
Fax Number	:	305-538-8616

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

Provider Enumeration Date	:	09/30/2009
Last Update Date	:	09/30/2009

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