| Doctor Name: | ROBERT BORGREN |
| NPI Number: | 1134528029 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | C.A.P. |
| License Number: | 4473 |
| Business Practice Address: | 245 S Amelia Ave Deland, FL - 327245913 |
| Business Phone Number: | 3862585050 |
| Business Fax Number: | 3867384838 |
| Mailing Address: | Po Box 2196, DAYTONA BEACH |
| State: | FL |
| Postal Code: | 321152196 |
| Phone Number: | 3862585050 |
| Fax Number: | 3867384838 |
| NPI Enumeration Date: | 08/18/2014 |
| NPI Last Update Date: | 08/18/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | 4473 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |