Provider Demographics
NPI:1205989563
Name:SEFCIK, ROBERT R (ATC)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:R
Last Name:SEFCIK
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
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Mailing Address - Street 1:3563 PHILLIPS HWY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207-5663
Mailing Address - Country:US
Mailing Address - Phone:904-202-4332
Mailing Address - Fax:904-202-4392
Practice Address - Street 1:3563 PHILLIPS HWY
Practice Address - Street 2:SUITE 202
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207-5663
Practice Address - Country:US
Practice Address - Phone:904-202-4332
Practice Address - Fax:904-202-4392
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAL22162255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer