# ROBERT B DEHGAN MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750555777
- **Authorized official:** ROBERT B DEHGAN (CEO/OWNER)
- **Authorized official phone:** (904) 247-1919

## Contact information

- **Practice address:** 460 OSCEOLA AVE, JACKSONVILLE, FL 32250-4078
- **Practice address phone:** (904) 247-1919
- **Practice address fax:** (904) 246-0301
- **Mailing address:** 460 OSCEOLA AVE, JACKSONVILLE, FL 32250-4078
- **Mailing address phone:** (904) 247-1919
- **Mailing address fax:** (904) 246-0301

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 204C00000X | Sports Medicine (Neuromusculoskeletal Medicine) Physician | ME 16903 | FL | Yes |

## Other

- **Enumeration date:** 04/22/2008
- **Last updated:** 03/12/2010