Healthcare Provider Details

I. General information

NPI: 1124064936
Provider Name (Legal Business Name): ROBERT N SHOBE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/21/2006
Last Update Date: 02/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3131 N MCMULLEN BOOTH RD
CLEARWATER FL
33761-2008
US

IV. Provider business mailing address

3131 N MCMULLEN BOOTH RD
CLEARWATER FL
33761-2008
US

V. Phone/Fax

Practice location:
  • Phone: 727-726-8871
  • Fax: 727-726-8571
Mailing address:
  • Phone: 727-726-8871
  • Fax: 727-726-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME51649
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: