Provider Demographics
NPI:1063496438
Name:ALBERGO, ROBERT PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:PATRICK
Last Name:ALBERGO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4132 WOODLANDS PARKWAY
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3494
Mailing Address - Country:US
Mailing Address - Phone:727-786-5100
Mailing Address - Fax:727-789-8344
Practice Address - Street 1:4132 WOODLANDS PARKWAY
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-3494
Practice Address - Country:US
Practice Address - Phone:727-786-5100
Practice Address - Fax:727-789-8344
Is Sole Proprietor?:No
Enumeration Date:2005-11-30
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL54120207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL009786600Medicaid
FL009786600Medicaid