MEDICARE: DEWEY ROBBIANO JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	076666-1	NY

General Provider Information

NPI Number	:	1427506021
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEWEY ROBBIANO JR. MD

Provider Business Mailing Address
First Line	:	3333 NE 34TH ST APT 1210
Second Line	:	APT 1210
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6915
Country	:	US
Telephone Number	:	954-564-0654
Fax Number	:	123-456-7890

Provider Business Practice Location Address
First Line	:	3333 NE 34TH ST APT 1210
Second Line	:	APT 1210
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-6915
Country	:	US
Telephone Number	:	954-564-0654
Fax Number	:	123-456-7890

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2016
Last Update Date	:	09/13/2016

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