Healthcare Provider Details

I. General information

NPI: 1962063008
Provider Name (Legal Business Name): ROBERT WILLIAM DEJOY III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2019
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1399 HAMLET AVE
CLEARWATER FL
33756-3331
US

IV. Provider business mailing address

1840 MEASE DR STE 307
SAFETY HARBOR FL
34695-6605
US

V. Phone/Fax

Practice location:
  • Phone: 727-441-4526
  • Fax: 727-266-4590
Mailing address:
  • Phone: 727-725-6128
  • Fax: 727-725-6168

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberOS23685
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: