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Individual

DR. ROBERT FITZGERALD VASSALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
8201 PETERS RD, SUITE 1000, PLANTATION, FL 33324-3265
(954) 447-9938
(954) 447-9431
Mailing address
8201 PETERS RD, SUITE 1000, PLANTATION, FL 33324-3265
(954) 447-9938
(954) 447-9431

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
ME0075365
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
253811302
FL
05
253811303
FL
01
42906
BLUECROSSBLUESHIELD#
FL
01
K7618
MEDICARE PTAN
FL
Enumeration date
10/25/2006
Last updated
06/26/2015
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