Theobald, Michael R
Theobald, Michael R is an individual health care provider with primary practice located at 14551 Hope Center Loop Ste 100 , Fort Myers FL 33912-4705. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Theobald, Michael R can be contacted via phone (239) 936-2316.Contact Information
Primary practice address
14551 Hope Center Loop Ste 100
Fort Myers FL 33912-4705
Phone: (239) 936-2316
Fax: (239) 834-6106
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | ME73419 | Florida |
Profile Details
| NPI number | 1952393464 |
|---|---|
| LBN Legal business name | Theobald, Michael R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Feb 13th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952393464 | NPPES |
| Florida | MEDICAID | 252181400 | |
| Florida | Other | 300085121 | |
| Florida | Other | 300085120 |
Popular Providers
-
Jacob, Kenneth Michael
19460 Caladesi Dr , Fort Myers FL 33967-5572 -
Santucci, Gail M
8791 Conference Dr Suite 1, Fort Myers FL 33919-5822 -
Amatulle, Philip
3680 Broadway , Fort Myers FL 33901-8005 -
Fueredi, Adam
3660 Broadway , Fort Myers FL 33901-8005 -
Banas, Jon Michael
3680 Broadway , Fort Myers FL 33901-8005 -
Gutstein, Laurie Lynn
6013 W Riverside Dr , Fort Myers FL 33919-1636 -
Muehlenbein, Stephen J
14551 Hope Center Loop Ste 100 , Fort Myers FL 33912-4705 -
Zekan, Thomas J
13813 Metro Pkwy , Fort Myers FL 33912-4343