Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | ME0067870 | FL |
NPI | 1053524116 |
---|---|
Provider Name | Robert A Oesterle |
First Address | St. Augustine, FL 32086-3703 |
Second Address | St. Augustine, FL 32086-3703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 30/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
252004400 | (05) | FL |
G38265 | (02) | FL |