Individual
DR. MARSHALL L TEITELBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
641 UNIVERSITY BLVD, SU. 206, JUPITER, FL 33458-2791
(561) 630-8530
(561) 630-8531
Mailing address
641 UNIVERSITY BLVD STE 206, JUPITER, FL 33458-2794
(561) 630-8530
(561) 630-8531
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME0064520
FL
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
ME0064520
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
377387600
—
FL
01
—
ME0064520
MEDICAL LICENSE
FL
Enumeration date
09/02/2006
Last updated
05/19/2014
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