Provider Demographics
NPI:1073527958
Name:RELKIN, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:RELKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6101 NW 60TH AVE
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4453
Mailing Address - Country:US
Mailing Address - Phone:954-227-9910
Mailing Address - Fax:954-757-6498
Practice Address - Street 1:6909 SW 18TH ST
Practice Address - Street 2:SUITE A202
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-7078
Practice Address - Country:US
Practice Address - Phone:561-347-8382
Practice Address - Fax:561-347-8487
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL72757208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
C63019Medicare UPIN