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Deactivated NPI 1245923283 Deactivated / Inactive NPI Male Practitioner

Robert E Petersen

Technician/Technologist - Optician • Jacksonville, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Robert Petersen has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 26, 2023
NPI Deactivation Date July 26, 2023
Total Practice Duration ~1 Years of Practice (2023 – 2023)

Professional Overview & Biography Verified Profile Summary

Robert Petersen was a registered Technician/Technologist - Optician practicing in Jacksonville, FL. Throughout an active medical career spanning 1 years, Robert Petersen provided care at the practice location at 8808 BEACH BLVD until profile deactivation on 2023-07-26.

Practice Location & Contact Primary Location

Practice Address

8808 Beach Blvd

Jacksonville, FL 322164600

Telephone 9042353158
Fax 9046411240
Associated Practice Facility / Clinic
🏢 Wal-Mart Stores East Lp Facility NPI 1316964786

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician/Technologist - Optician in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
25 Specialists

Practicing in Jacksonville, FL (686 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Technician/Technologist - Optician Primary Specialty

NUCC Taxonomy Code: 156FX1800X

Opticians help fit eyeglasses and contact lenses, following prescriptions from Ophthalmologists and Optometrists. They also help customers decide which eyeglass frame or contact lenses to buy.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Mary Williams

Technician/Technologist - Optician

NPI 1912825639

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated July 26, 2023

Record deactivated on July 26, 2023

NPI Profile Active June 10, 2023

NPI status registered as active in NPPES database

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Updated Practice Location June 10, 2023

Registered at 8808 BEACH BLVD, JACKSONVILLE, FL 322164600 (Tel: 9042353158)

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Updated Business Mailing Address June 10, 2023

Registered at 8808 BEACH BLVD, JACKSONVILLE, FL 322164600 (Tel: 9042353158)

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Provider Name / Credentials Updated June 10, 2023

Recorded as ROBERT PETERSEN

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Medical Taxonomy / Specialty Registered (Primary Specialty) June 10, 2023

Technician/Technologist

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Initial NPI Registration & Enumeration May 26, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1245923283
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 26, 2023
Last Update: June 10, 2023
Deactivation Date: July 26, 2023

Mailing Address

8808 Beach Blvd

Jacksonville, FL 322164600

Phone: 9042353158

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.