Provider Demographics
NPI:1528175718
Name:EDGERTON, ROBERT ALBERT JR (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:ALBERT
Last Name:EDGERTON
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
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Mailing Address - Street 1:3978 BISHOPWOOD CT W
Mailing Address - Street 2:UNIT 202
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34114-3562
Mailing Address - Country:US
Mailing Address - Phone:239-348-3818
Mailing Address - Fax:239-348-3818
Practice Address - Street 1:625 N COLLIER BLVD
Practice Address - Street 2:
Practice Address - City:MARCO ISLAND
Practice Address - State:FL
Practice Address - Zip Code:34145-1916
Practice Address - Country:US
Practice Address - Phone:239-393-0843
Practice Address - Fax:239-642-9841
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPS36794183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist