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1124103981
MICHAEL ROBERT DE RIESTHAL
GAINESVILLE, FL
NPI
1124103981
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: FL SA 6898)
Enumeration Date
2006-10-27
Last Update Date
2007-07-08
Business Address
Dr. MICHAEL ROBERT DE RIESTHAL Ph.D
1601 SW ARCHER RD NEUROLOGY SERVICE (127)
GAINESVILLE, FL 32608-1135
Phone number: 352-376-1611
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Mailing Address
Dr. MICHAEL ROBERT DE RIESTHAL Ph.D
9488 NW 24TH RD
GAINESVILLE, FL 32606-9203
Phone number: 352-331-1786
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