Healthcare Provider Details

I. General information

NPI: 1629060140
Provider Name (Legal Business Name): ROBERT SCHICKLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3716 W OAKLAND PARK BLVD
LAUDERDALE LAKES FL
33311-1134
US

IV. Provider business mailing address

1608 SE 3RD AVE THIRD FLOOR PBO
FORT LAUDERDALE FL
33316-2564
US

V. Phone/Fax

Practice location:
  • Phone: 954-759-7557
  • Fax: 954-733-9155
Mailing address:
  • Phone: 954-847-4273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberME44087
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: