MEDICARE: DR. ROBERT D SANTROCK M.D.

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	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	28473	SC
2	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	20792	WV
3	207X00000X	Orthopaedic Surgery Physician	ME151129	FL
4	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	ME151129	FL
5	207XX0004X	Orthopaedic Foot and Ankle Surgery Physician	35.08143	OH

General Provider Information

NPI Number	:	1497731780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT D SANTROCK M.D.

Provider Business Mailing Address
First Line	:	PO BOX 746647
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6647
Country	:	US
Telephone Number	:	904-202-2092
Fax Number	:	904-376-4075

Provider Business Practice Location Address
First Line	:	1348 S 18TH ST STE 200
Second Line	:
City	:	FERNANDINA BEACH
State	:	FL
Zip	:	32034-4785
Country	:	US
Telephone Number	:	904-202-6683
Fax Number	:	904-376-3062

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

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	01/30/2026

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Directions to “ DR. ROBERT D SANTROCK M.D.” Practice Location

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