Provider Demographics
NPI:1881770014
Name:CULLEN, ROBERT F JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:F
Last Name:CULLEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15715 S DIXIE HWY
Mailing Address - Street 2:SUITE 407
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33157-1800
Mailing Address - Country:US
Mailing Address - Phone:305-253-4600
Mailing Address - Fax:305-253-4602
Practice Address - Street 1:15715 S DIXIE HWY STE 407
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-1812
Practice Address - Country:US
Practice Address - Phone:305-253-4600
Practice Address - Fax:305-253-4602
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-31
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME00168812084N0400X, 2084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL050154900Medicaid
FL117849800Medicaid
D59558Medicare UPIN