Healthcare Provider Details

I. General information

NPI: 1740210731
Provider Name (Legal Business Name): ROBERT DUNCAN CARROLL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 SW ARCHER RD
GAINESVILLE FL
32608-1135
US

IV. Provider business mailing address

3880 NW 23RD TER APT 102
GAINESVILLE FL
32605-5645
US

V. Phone/Fax

Practice location:
  • Phone: 352-376-1611
  • Fax: 352-379-4015
Mailing address:
  • Phone: 352-338-1287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number231787
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: