Provider Demographics
NPI:1548270739
Name:ULLMAN, ROBERT L (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:ULLMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2000 N OCEAN BLVD
Mailing Address - Street 2:#102
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-7825
Mailing Address - Country:US
Mailing Address - Phone:561-912-0260
Mailing Address - Fax:561-912-0640
Practice Address - Street 1:2900 N MILITARY TRL
Practice Address - Street 2:SUITE 244 NORTH
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-6365
Practice Address - Country:US
Practice Address - Phone:561-912-0260
Practice Address - Fax:561-912-0640
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-09
Last Update Date:2011-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME96554207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL96554OtherME
FLAB514YMedicare PIN
FL96554OtherME