Provider Demographics
NPI:1629087036
Name:SIGNOR, ROBERT N JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:N
Last Name:SIGNOR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:201 HEALTH PARK BLVD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32086
Mailing Address - Country:US
Mailing Address - Phone:904-824-1776
Mailing Address - Fax:904-825-1270
Practice Address - Street 1:201 HEALTH PARK BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:SAINT AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086
Practice Address - Country:US
Practice Address - Phone:904-824-1776
Practice Address - Fax:904-825-1270
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0046592207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E15795Medicare UPIN
FL09076WMedicare ID - Type Unspecified