Healthcare Provider Details

I. General information

NPI: 1073527958
Provider Name (Legal Business Name): ROBERT A RELKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6909 SW 18TH ST SUITE A202
BOCA RATON FL
33433-7078
US

IV. Provider business mailing address

6101 NW 60TH AVE
PARKLAND FL
33067-4453
US

V. Phone/Fax

Practice location:
  • Phone: 561-347-8382
  • Fax: 561-347-8487
Mailing address:
  • Phone: 954-227-9910
  • Fax: 954-757-6498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number72757
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: