Robert C Udell DO LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

OS7144 Issued in FL

Legal business name

ROBERT C UDELL DO LLC

Practice address

1980 N Atlantic Ave
Suite 1010
Cocoa Beach, FL 32931-5213

Phone

(321) 868-0360

Fax

(321) 799-4968

NPI assigned

Jun 15, 2006

Last updated

Aug 28, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Sandi Laroche

Title

Mso Credentialing Coordinator

Phone

(321) 449-4168

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251417600000",
    "number": "1386688257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 N SYKES CREEK PKWY",
            "address_2": "# 300",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329533488",
            "telephone_number": "321-449-4168",
            "fax_number": "321-449-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 N ATLANTIC AVE",
            "address_2": "SUITE 1010",
            "city": "COCOA BEACH",
            "state": "FL",
            "postal_code": "329315213",
            "telephone_number": "321-868-0360",
            "fax_number": "321-799-4968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C UDELL DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-15",
        "last_updated": "2009-08-28",
        "status": "A",
        "authorized_official_last_name": "LAROCHE",
        "authorized_official_first_name": "SANDI",
        "authorized_official_title_or_position": "MSO CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "321-449-4168"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "OS7144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Cocoa Beach, FL
• Providers in Cocoa Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.