Robert Gary Victome, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN13708 Issued in FL

Practice address

6137 Lake Worth Rd
Greenacres, FL 33463-3074

Phone

(561) 357-1009

Fax

(561) 969-7624

NPI assigned

Nov 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Networks

• Freedom Health HMO Network

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Centaurus Healthcare, Incorporated

  • Optometrist
  • Lake Worth, FL
  • NPI 1366984155
  NPD (past) Authorized official
• Mil-Lake Dental

  • General Practice Physician
  • Lake Worth, FL
  • NPI 1346798063
  NPD (past) Authorized official

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476316800000",
    "number": "1437238516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6137 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633074",
            "telephone_number": "561-357-1009",
            "fax_number": "561-969-7624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6137 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633074",
            "telephone_number": "561-357-1009",
            "fax_number": "561-969-7624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VICTOME",
        "first_name": "ROBERT",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN13708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "650670857",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "076810300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Humberto Jesus Valladares Fragoso
• Melina Valverde Trevin, RBT
• Luz Stella Vasquez
• Daimarelis Verdecia Valdivia
• Ericson Vibert, DC
• Mariem Victores, RBT
• Yuney Vidal Ramirez
• Viera Santos Pediatric
• Johany Villalobos Hidalgo
• Jaslyn Villatoro Guzman

• General Practice Dentistry in Greenacres, FL
• Providers in Greenacres, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.