Organization
ROBERT B DEHGAN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT B DEHGAN (CEO/OWNER)
(904) 247-1919
Entity
Organization
Contact information
Practice address
460 OSCEOLA AVE, JACKSONVILLE, FL 32250-4078
(904) 247-1919
(904) 246-0301
Mailing address
460 OSCEOLA AVE, JACKSONVILLE, FL 32250-4078
(904) 247-1919
(904) 246-0301
Taxonomy
Speciality
Code
Description
License number
State
204C00000X
Sports Medicine (Neuromusculoskeletal Medicine) Physician
Primary
ME 16903
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
049429100
—
FL
01
—
16803
BCBS
FL
01
—
250011286
RR MEDICARE
FL
Enumeration date
04/22/2008
Last updated
03/12/2010
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