Healthcare Provider Details

I. General information

NPI: 1871563031
Provider Name (Legal Business Name): ROBERT CYWES M.D., PHD.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 12/08/2023
Certification Date: 12/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6817 SOUTHPOINT PKWY STE 703
JACKSONVILLE FL
32216-6280
US

IV. Provider business mailing address

19906 LOXAHATCHEE POINTE DR
JUPITER FL
33458-1815
US

V. Phone/Fax

Practice location:
  • Phone: 904-410-3934
  • Fax: 904-503-4832
Mailing address:
  • Phone: 904-412-3134
  • Fax: 561-627-5069

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0120X
TaxonomyPediatric Surgery Physician
License NumberM-14497
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberME85894
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: