Doctor Name: | DR. ROBERT B WYKO |
NPI Number: | 1891730685 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DO |
License Number: | OS3673 |
Business Practice Address: | 1022 Main St Suite M Dunedin, FL - 346985238 |
Business Phone Number: | 7277337922 |
Business Fax Number: | 7277386205 |
Mailing Address: | 1022 Main St, Suite M DUNEDIN |
State: | FL |
Postal Code: | 346985238 |
Phone Number: | 7277337922 |
Fax Number: | 7277386205 |
NPI Enumeration Date: | 06/17/2006 |
NPI Last Update Date: | 09/01/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | OS3673 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |