Provider Demographics
NPI:1487645396
Name:CLEMENT, ROBERT J (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:CLEMENT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9964 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32817-1802
Mailing Address - Country:US
Mailing Address - Phone:407-261-2954
Mailing Address - Fax:407-261-2918
Practice Address - Street 1:9964 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1802
Practice Address - Country:US
Practice Address - Phone:407-261-2954
Practice Address - Fax:407-261-2918
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2020-05-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME38133207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL257663500Medicaid
FL257663500Medicaid
FL44843ZMedicare PIN