Individual
ROBERT RAY DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10080 BALAYE RUN DR, TAMPA, FL 33619-7902
(813) 490-6100
(813) 490-6105
Mailing address
1033 DR MARTIN LUTHER KING JR ST N, STE. 108, ST PETERSBURG, FL 33701-1547
(727) 456-4250
(727) 346-1044
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME52195
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048964600
—
FL
01
—
07123
BCBS
FL
01
—
295449
AVMED
FL
Enumeration date
08/13/2006
Last updated
02/23/2010
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