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Individual

DR. ROBERT DANIEL COLUCCI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
285 CLYDE MORRIS BLVD STE 300, ORMOND BEACH, FL 32174-8144
(239) 690-6906
(386) 262-1628
Mailing address
740 DUNLAWTON AVE, PORT ORANGE, FL 32127-4239
(386) 763-1000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
199981
NY
2084P0800X
Psychiatry Physician
Primary
OS18094
FL
2084P0804X
Child & Adolescent Psychiatry Physician
199981
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02126507
NY
05
02916365
NY
Enumeration date
11/14/2006
Last updated
11/05/2024
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