Individual
ROBERT ULSETH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 S LINE AVE, INVERNESS, FL 34452-4605
(352) 344-4791
(352) 344-3822
Mailing address
PO BOX 1925, LADY LAKE, FL 32158-1925
(352) 553-4075
(888) 770-3208
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME56394
FL
208VP0000X
Pain Medicine Physician
Primary
ME56394
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
08559
BLUE SHIELD PROV #
FL
Enumeration date
09/13/2005
Last updated
07/03/2023
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