Individual
DR. ROBERT J COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5018 DR PHILLIPS BLVD, ORLANDO, FL 32819-3310
(407) 363-5753
(407) 351-2141
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPARTMENT, ROCKLAND, DE 19732-0191
(302) 651-4488
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
ME0065025
FL
208000000X
Pediatrics Physician
Primary
ME0065025
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008475200
—
FL
Enumeration date
06/01/2006
Last updated
03/28/2014
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