MEDICARE: KIM ROBUSTO DO

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	207Q00000X	Family Medicine Physician	34008135R	OH

General Provider Information

NPI Number	:	1649370917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM ROBUSTO DO

Provider Business Mailing Address
First Line	:	PO BOX 92997
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44194-2997
Country	:	US
Telephone Number	:	330-425-2212
Fax Number	:	330-425-2779

Provider Business Practice Location Address
First Line	:	8819 COMMONS BLVD STE 100
Second Line	:
City	:	TWINSBURG
State	:	OH
Zip	:	44087-4102
Country	:	US
Telephone Number	:	330-425-2212
Fax Number	:	330-425-2779

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	12/18/2020

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Directions to “ KIM ROBUSTO DO” Practice Location

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