Provider Demographics
NPI:1518995448
Name:KUYKENDALL, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:KUYKENDALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:R. CRAIG
Other - Middle Name:
Other - Last Name:KUYKENDALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1720 SE 16TH AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4620
Mailing Address - Country:US
Mailing Address - Phone:352-369-0288
Mailing Address - Fax:352-867-1053
Practice Address - Street 1:1720 SE 16TH AVE STE 303
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4620
Practice Address - Country:US
Practice Address - Phone:352-369-0288
Practice Address - Fax:352-867-1053
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53796208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL07329OtherBCBS FL
FL07329BOtherBCBSFL HMO
FL07329AOtherBCBSFL HMO
FL041517100Medicaid
FL07329WMedicare PIN
FLP00220718Medicare PIN
FL07329UMedicare PIN
FLD21201Medicare UPIN
FLP00283511Medicare PIN
FL780001925Medicare PIN
FL07329TMedicare PIN
FL07329BOtherBCBSFL HMO
FL041517100Medicaid
FL07329XMedicare PIN
FL07329AOtherBCBSFL HMO
FL07329VMedicare PIN