Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Michael R Theobald, MD

Individual provider Diagnostic Radiology Physician · NPI 1952393464

Dr. Michael R Theobald, MD is a Diagnostic Radiology in Fort Myers, Florida. Graduated from Georgetown University School of Medicine in 1991, 35 years ago. Practices with Radiology Regional Center P A, a 58-clinician group and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
35
Trained at
Georgetown University School of Medicine
Licensed in
FL
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

14551 Hope Center Loop Ste 100
Fort Myers, FL 33912-4705
Phone: (239) 936-2316
Fax: (239) 834-6106
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence ME73419 (FL)

Record details

NPI number1952393464
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 19, 2005
Last updated in NPPESFebruary 13, 2024
Certification dateFebruary 13, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 1991 (35 years in practice)
Group practice Radiology Regional Center P A — 58 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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