Provider Demographics
NPI:1881692838
Name:BUCK, ROBERT JAMES III (DO)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:BUCK
Suffix:III
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11881-A E COLONIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4723
Mailing Address - Country:US
Mailing Address - Phone:407-367-0064
Mailing Address - Fax:407-322-5309
Practice Address - Street 1:1507 N JOHN YOUNG PKWY
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741-3214
Practice Address - Country:US
Practice Address - Phone:855-226-6633
Practice Address - Fax:866-285-7068
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS7810207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL276736OtherWELLCARE
FL46011OtherBC/BS
FL270276200Medicaid
FL46011OtherBC/BS
FL276736OtherWELLCARE
FLI43029Medicare UPIN