Provider Demographics
NPI:1811268626
Name:OLLER, ROBERT S (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:OLLER
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 1:3200 S. UNIVERSITY DRIVE
Mailing Address - Street 2:ASSEMBLY BLDG. 2, ROOM 202
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33328-2018
Mailing Address - Country:US
Mailing Address - Phone:954-262-4399
Mailing Address - Fax:954-262-1172
Practice Address - Street 1:3200 S. UNIVERSIT DRIVE
Practice Address - Street 2:SANFORD L. ZIFF BLDG.
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33328-2018
Practice Address - Country:US
Practice Address - Phone:954-262-4100
Practice Address - Fax:954-262-2271
Is Sole Proprietor?:No
Enumeration Date:2012-01-25
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS2443207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine