Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | OS-9857 | FL |
NPI | 1275590390 |
---|---|
Provider Name | Dr. Robert Thomas O'leary |
First Address | Estero, FL 34134-5012 |
Second Address | Estero, FL 34134 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 02/09/2020 |