Provider Demographics
NPI:1053849927
Name:ROBERT F. CULLEN, JR., MD., PA
Entity Type:Organization
Organization Name:ROBERT F. CULLEN, JR., MD., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:CULLEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:350-253-4600
Mailing Address - Street 1:15715 S DIXIE HWY STE 407
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1812
Mailing Address - Country:US
Mailing Address - Phone:305-253-4600
Mailing Address - Fax:305-253-4602
Practice Address - Street 1:15715 S DIXIE HWY STE 407
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33157
Practice Address - Country:US
Practice Address - Phone:305-253-4600
Practice Address - Fax:305-253-4602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-23
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME168812084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty