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NPI Code Detail

MEDICARE: ROBERT BISSET MD

MEDICARE: ROBERT BISSET MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianME35317FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
164430WOTHERFLMEDICARE

General Provider Information

NPI Number : 1538153358
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT BISSET MD
Provider Business Mailing Address
First Line : 3300 S FISKE BLVD
Second Line :
City : ROCKLEDGE
State : FL
Zip : 32955-4306
Country : US
Telephone Number : 321-549-0830
Fax Number : 321-951-7408
Provider Business Practice Location Address
First Line : 1220 N HIGHWAY A1A STE 147
Second Line :
City : INDIALANTIC
State : FL
Zip : 32903-2858
Country : US
Telephone Number : 321-549-0830
Fax Number : 321-951-9127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 06/26/2019

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