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General NPI Number Information
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NPI Number | 1942202981
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Entity Type | Individual
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Provider Name | ROBERT JAMES SOLLACCIO M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 1561 W FAIRBANKS AVE SUITE 100
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City | WINTER PARK
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State | FL
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Zip | 32789-4678
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Country | US
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Telephone | 888-860-4766
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Fax | 888-890-4766
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Provider Business Mailing Address
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Address Line | PO BOX 690487 SUITE 2
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City | ORLANDO
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State | FL
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Zip | 32869-0487
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Country | US
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Telephone | 888-860-4766
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Fax | 888-890-4766
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | ME56371
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License Number State | FL
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