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Dr. Michael R Theobald, MD
Diagnostic Radiology Physician in Fort Myers, Florida
NPI 1952393464

Michael R Theobald is a Diagnostic Radiology Physician based in Fort Myers, FL and is specialized in Diagnostic Radiology. Michael R Theobald practices in Fort Myers, FL and has the professional credentials of MD. The NPI Number for Michael R Theobald is 1952393464 and holds a License No. ME73419 (Florida).

The current practice location address for Michael R Theobald is 14551 Hope Center Loop Ste 100, Fort Myers, FL and can be reached out via phone at 239-936-2316 and via fax at 239-834-6106.

Location: 14551 Hope Center Loop Ste 100, Fort Myers, FL, 33901-8005
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1952393464
Provider Name
Michael R Theobald
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
14551 Hope Center Loop Ste 100, Fort Myers, FL, 33901-8005
Phone Number
239-936-2316
Fax Number
239-834-6106
Provider Enumeration Date
08/19/2005
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
252181400 05 FL
300085121 01 FL RR MEDICARE
300085120 01 FL RR MEDICARE
institution
Provider Business Practice Location Address Details
Address
14551 Hope Center Loop Ste 100
City
Fort Myers
State
Florida
Zip
33912-4705
Phone Number
239-936-2316
Fax Number
239-834-6106
person
Provider Business Mailing Address Details
Address
14551 Hope Center Loop Ste 100
City
Fort Myers
State
Florida
Zip
33912-4705
Phone Number
239-936-2316
Fax Number
239-834-6106
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Radiology
Speciality
Diagnostic Radiology
Taxonomy
2085R0202X
License No.
ME73419 (Florida)
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
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