Individual
ROBERT M PAIGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1223 GATEWAY DR, MELBOURNE, FL 32901-2607
(321) 549-0677
(321) 722-2432
Mailing address
PO BOX 2400, MELBOURNE, FL 32902-2400
(321) 725-4500
(321) 722-2432
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME42214
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010961600
—
FL
05
—
052106000
—
FL
01
—
05568S
MEDICARE
FL
01
—
05568X
FL HFMG MEDICARE
FL
01
—
300118920
RR MEDICARE
FL
01
—
P01164171
FL RR MEDICARE
FL
Enumeration date
12/07/2005
Last updated
03/13/2020
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