Provider Demographics
NPI:1568424729
Name:PRITT, ROBERT BERNIE (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BERNIE
Last Name:PRITT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:13670 METROPOLIS AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4346
Mailing Address - Country:US
Mailing Address - Phone:239-489-0800
Mailing Address - Fax:239-489-3274
Practice Address - Street 1:13670 METROPOLIS AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4346
Practice Address - Country:US
Practice Address - Phone:239-489-0800
Practice Address - Fax:239-489-3274
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2008-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS6816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE87173Medicare UPIN
FL80958Medicare ID - Type Unspecified