Provider Demographics
NPI:1346345550
Name:FELDMAN, ROBERT L (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:L
Last Name:FELDMAN
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 1:125 SW 11TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-0967
Mailing Address - Country:US
Mailing Address - Phone:352-354-9000
Mailing Address - Fax:352-620-0255
Practice Address - Street 1:125 SW 11TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-0967
Practice Address - Country:US
Practice Address - Phone:352-354-9000
Practice Address - Fax:352-620-0255
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME26083207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL037784800Medicaid
FL55076OtherBLUE CROSS BLUE SHIELD
FL55076OtherBLUE CROSS BLUE SHIELD
FL037784800Medicaid
FL060040196Medicare PIN