Provider Demographics
NPI:1598746968
Name:RABIEA, ROBERT J (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:RABIEA
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 1:629A E HILLSBORO BLVD
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33441-3517
Mailing Address - Country:US
Mailing Address - Phone:954-698-9399
Mailing Address - Fax:954-698-6963
Practice Address - Street 1:9603 SAVONA WINDS DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-9756
Practice Address - Country:US
Practice Address - Phone:954-698-9399
Practice Address - Fax:954-698-6963
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME860202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD015743100Medicaid
AZ73380902Medicaid
ID806445500Medicaid
OH2309835Medicaid
FL300134829OtherRXR MEDICARE
MT0067694Medicaid
NE10025061400Medicaid
PA1017661060001Medicaid
3195845111518OtherTRICARE WEST
FL37364OtherBCBS
SD7706310Medicaid
IN200933300Medicaid
WY118420200Medicaid
FL37364OtherBCBS
MD015743100Medicaid
FLU1264IMedicare PIN
PA1017661060001Medicaid
SD7706310Medicaid