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Organization
ROBERT P. BEWLEY, DPM, PA
Active
Organization
ROBERT P. BEWLEY, DPM, PA
Active
Other names
Lakeside Centre for Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT P BEWLEY D.P.M. (OWNER)
(352) 728-1252
Entity
Organization
Contact information
Practice address
601 E DIXIE AVE, PLAZA 804, LEESBURG, FL 34748-5953
(352) 728-1252
(352) 728-0079
Mailing address
601 E DIXIE AVE, PLAZA 804, LEESBURG, FL 34748-5953
(352) 728-1252
(352) 728-0079
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
PO693
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45125
BLUE CROSS/BLUE SHIELD
FL
01
—
CF7533
RAILROAD MEDICARE
FL
01
—
K1457
MEDICARE PTAN
FL
Enumeration date
07/29/2006
Last updated
04/08/2008
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