MEDICARE: DR. ROBERT JAMES DECKER JR. 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	207Q00000X	Family Medicine Physician	25MB09780600	NJ
2	207Q00000X	Family Medicine Physician	012197	OH
3	390200000X	Student in an Organized Health Care Education/Training Program
4	261QU0200X	Urgent Care Clinic/Center	OS16668	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1326470139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT JAMES DECKER JR. D.O

Provider Business Mailing Address
First Line	:	10033 OAK QUARRY DR
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32832-5645
Country	:	US
Telephone Number	:	570-574-0978
Fax Number	:

Provider Business Practice Location Address
First Line	:	7751 KINGSPOINTE PKWY
Second Line	:
City	:	ORLANDO
State	:	FL
Zip	:	32819-6500
Country	:	US
Telephone Number	:	407-581-9672
Fax Number	:

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

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	05/13/2020

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