Robert M Mandelkorn, M.D., Inc.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

ME80929 Issued in FL

Legal business name

ROBERT M MANDELKORN, M.D., INC.

Practice address

1510 Royal Palm Square Blvd
Ste 106
Fort Myers, FL 33919-1068

Phone

(239) 939-3937

Fax

(239) 275-8045

NPI assigned

Aug 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Robert Marc Mandelkorn, M.D.NPI 1457455990

Title

President

Phone

(239) 939-3937

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Marc Mandelkorn, M.D.

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1457455990
  Medicare reassignment NPD Authorized official
• Robin Thad Goodwin, M.D.

  • Ophthalmology Physician
  • Fort Myers, FL
  • NPI 1558353748
  NPD (past)

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

{
    "created_epoch": "1280966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280966400000",
    "number": "1871807420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1510 ROYAL PALM SQUARE BLVD",
            "address_2": "STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191068",
            "telephone_number": "239-939-3937",
            "fax_number": "239-275-8045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1510 ROYAL PALM SQUARE BLVD",
            "address_2": "STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339191068",
            "telephone_number": "239-939-3937",
            "fax_number": "239-275-8045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M MANDELKORN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-05",
        "last_updated": "2010-08-05",
        "status": "A",
        "authorized_official_last_name": "MANDELKORN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-939-3937",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "FL",
            "license": "ME80929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA MEDICAL LICENSE",
            "identifier": "ME80929",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1457455990",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert B Pritt DO PA
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• Robert E Fischer DDS PA Inc
• Robert E Watkins Jr
• Robert E Watkins Jr DC Inc (SWFL Spinal Care)
• Robert P Casola DO PA
• Robert Volski & Associates Inc
• Robert W Heiser MD PA
• Robert W. Pollack, MD, PLLC
• Jade Roberts

• Ophthalmology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Ophthalmology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.