MEDICARE: ROBERT ALAN SKOTNICKI D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	OS004652L	PA
2	207RC0000X	Cardiovascular Disease Physician	OS13035	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060012838	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215930334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT ALAN SKOTNICKI D.O.

Provider Business Mailing Address
First Line	:	1020 LAKE SUMTER LNDG
Second Line	:
City	:	THE VILLAGES
State	:	FL
Zip	:	32162-2699
Country	:	US
Telephone Number	:	352-674-8820
Fax Number	:	352-674-8919

Provider Business Practice Location Address
First Line	:	1400 N US HIGHWAY 441
Second Line	:	SUITE 810
City	:	THE VILLAGES
State	:	FL
Zip	:	32159-8975
Country	:	US
Telephone Number	:	352-674-8700
Fax Number	:	352-674-8714

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/18/2025

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Directions to “ ROBERT ALAN SKOTNICKI D.O.” Practice Location

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