Provider Demographics
NPI:1518947118
Name:TOBIAS, HAL MARK (MD)
Entity Type:Individual
Prefix:DR
First Name:HAL
Middle Name:MARK
Last Name:TOBIAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:901 SE MONTEREY COMMONS BLVD
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34996-3352
Mailing Address - Country:US
Mailing Address - Phone:772-283-3414
Mailing Address - Fax:772-283-5451
Practice Address - Street 1:901 SE MONTEREY COMMONS BLVD
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34996-3352
Practice Address - Country:US
Practice Address - Phone:772-283-3414
Practice Address - Fax:772-283-5451
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL423492084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040638400Medicaid
D42146Medicare UPIN
FL96704Medicare ID - Type Unspecified