Robert B Dehgan MD PA

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

ME16903 Issued in FL

Legal business name

ROBERT B DEHGAN MD PA

Practice address

6500 Crill Ave
Palatka, FL 32177-6807

Phone

(386) 325-0570

NPI assigned

Apr 11, 2008

Last updated

Sep 2, 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

Robert B Dehgan, MD

Title

Ceo/ Owner

Phone

(904) 794-9180

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Robert B Dehgan MD PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Robert B Dehgan MD PA

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Jacksonville, FL
  • NPI 1750555777
  NPD tax ID

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

{
    "created_epoch": "1207872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1841463601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 OSCEOLA AVE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322504078",
            "telephone_number": "904-247-1919",
            "fax_number": "904-246-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 CRILL AVE",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321776807",
            "telephone_number": "386-325-0570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT B DEHGAN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-11",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "DEHGAN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO/ OWNER",
        "authorized_official_telephone_number": "904-794-9180",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "FL",
            "license": "ME16903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049429101",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "16803",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "250011286",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Whitney Lane Rigdon, APRN
• Mark Salvatore Ritchie, PA-C
• Maria-Josefina Santos Rivera, MD
• Angela Yvonne Rivers, L.M.T.
• Phillip Martin Robbins, DMD
• Robert de la Torre MD PA
• Morgann D. Robinson, PHARM.D.
• Ashlea Rombach
• Alfred Thomas Romero, M.D
• Cary Rose, MD

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Palatka, FL
• Providers in Palatka, FL by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 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.