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NPI Code Detail

MEDICARE: ROBERT E FOX PA-C

MEDICARE: ROBERT E FOX PA-C
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
1363AS0400XSurgical Physician AssistantPA1873FL
2363A00000XPhysician AssistantPA1873FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2Y09QZOTHERFLBLUE SHIELD OF FLORIDA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962431387
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT E FOX PA-C
Provider Business Mailing Address
First Line : 705 WELLS RD STE 300
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-2982
Country : US
Telephone Number : 386-287-0410
Fax Number : 386-287-0411
Provider Business Practice Location Address
First Line : 404 NW HALL OF FAME DR
Second Line :
City : LAKE CITY
State : FL
Zip : 32055-4833
Country : US
Telephone Number : 386-287-0410
Fax Number : 386-287-0411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2006
Last Update Date : 09/23/2024

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Directions to “ ROBERT E FOX PA-C” Practice Location

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