Provider Demographics
NPI:1396734943
Name:SHULTZ, ROBERT A (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:SHULTZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2572 W STATE RD 426
Mailing Address - Street 2:STE 1000
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8310
Mailing Address - Country:US
Mailing Address - Phone:407-478-0882
Mailing Address - Fax:407-359-8530
Practice Address - Street 1:2572 W STATE RD 426
Practice Address - Street 2:STE 1000
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8310
Practice Address - Country:US
Practice Address - Phone:407-478-0882
Practice Address - Fax:407-359-8530
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS5439207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology