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Organization
ROBERT W. WILSON, D.O., P.A.
Active
Organization
ROBERT W. WILSON, D.O., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT WILCOX WILSON D.O.,P.A. (OWNER)
(239) 598-5750
Entity
Organization
Contact information
Practice address
2940 IMMOKALEE RD, SUITE #2, NAPLES, FL 34110-1409
(239) 598-5750
Mailing address
2940 IMMOKALEE RD, SUITE #2, NAPLES, FL 34110-1409
(239) 598-5750
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
0S0006131
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202096
FL HEALTHY KIDS
FL
01
—
435695
GREAT WEST
—
01
—
80906
BLUE CROSS BLUE SHIELD
—
Enumeration date
04/16/2007
Last updated
08/22/2020
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