Provider Demographics
NPI:1609820455
Name:HYMAN, ROBERT JEFFREY (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JEFFREY
Last Name:HYMAN
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 1:10486 BERMUDA DR
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33026-4634
Mailing Address - Country:US
Mailing Address - Phone:954-436-3434
Mailing Address - Fax:954-436-3434
Practice Address - Street 1:8300 W SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5406
Practice Address - Country:US
Practice Address - Phone:954-577-6000
Practice Address - Fax:954-577-5816
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME59226174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE44855Medicare UPIN
FL14411Medicare ID - Type Unspecified