Organization
ROBERT M MANDELKORN, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT MARC MANDELKORN M.D. (PRESIDENT)
(239) 939-3937
Entity
Organization
Contact information
Practice address
1510 ROYAL PALM SQUARE BLVD, STE 106, FORT MYERS, FL 33919-1068
(239) 939-3937
(239) 275-8045
Mailing address
1510 ROYAL PALM SQUARE BLVD, STE 106, FORT MYERS, FL 33919-1068
(239) 939-3937
(239) 275-8045
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
ME80929
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457455990
INDIVIDUAL NPI
—
01
—
ME80929
FLORIDA MEDICAL LICENSE
FL
Enumeration date
08/05/2010
Last updated
08/05/2010
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