Provider Demographics
NPI:1407831498
Name:IKEMAN, ROBERT L (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:IKEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1945 VERSAILLES ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-6900
Mailing Address - Country:US
Mailing Address - Phone:941-365-0770
Mailing Address - Fax:941-955-8984
Practice Address - Street 1:1945 VERSAILLES ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239
Practice Address - Country:US
Practice Address - Phone:941-365-0770
Practice Address - Fax:941-955-8984
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME75668207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
493662OtherAETNA
FL44459OtherBCBS
G82070Medicare UPIN
493662OtherAETNA