Healthcare Provider Details

I. General information

NPI: 1417909128
Provider Name (Legal Business Name): ROBERT STRUBBE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11801 SW 90TH ST STE 201
MIAMI FL
33186-2182
US

IV. Provider business mailing address

PO BOX 198175
ATLANTA GA
30384-8175
US

V. Phone/Fax

Practice location:
  • Phone: 305-595-1317
  • Fax: 305-279-6813
Mailing address:
  • Phone: 305-595-1317
  • Fax: 786-787-2567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License NumberPA9103252
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: