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General NPI Number Information
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NPI Number | 1619351905
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Entity Type | Organization
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Legal Business Name | ROBERT L LIKENS, MD, PA
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Dates
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Enumeration Date | 07/16/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 515 STATE ROAD 436 STE 1000
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City | CASSELBERRY
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State | FL
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Zip | 32707-5341
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Country | US
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Telephone | 407-831-3456
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Fax |
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Provider Business Mailing Address
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Address Line | 515 STATE ROAD 436 STE 1000
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City | CASSELBERRY
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State | FL
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Zip | 32707-5341
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Country | US
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Telephone | 407-831-3456
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT L LIKENS
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Credential | MD
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Telephone | 407-831-3456
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME0012977
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License Number State | FL
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