Healthcare Provider Details

I. General information

NPI: 1922098417
Provider Name (Legal Business Name): ROBERT L QUIGLEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 04/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BENMORE DRIVE. SUITE 200
WINTER PARK FL
32792-4143
US

IV. Provider business mailing address

133 BENMORE DRIVE. SUITE 200
WINTER PARK FL
32792-4143
US

V. Phone/Fax

Practice location:
  • Phone: 407-646-7070
  • Fax: 407-646-7747
Mailing address:
  • Phone: 407-646-7070
  • Fax: 407-646-7747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME31885
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: