Healthcare Provider Details

I. General information

NPI: 1730136292
Provider Name (Legal Business Name): ROSS A. ROBINS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 03/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13139 SORRENTO RD
PENSACOLA FL
32507-8777
US

IV. Provider business mailing address

PO BOX 2699
PENSACOLA FL
32513-2699
US

V. Phone/Fax

Practice location:
  • Phone: 850-492-0543
  • Fax: 850-492-6340
Mailing address:
  • Phone: 850-475-4500
  • Fax: 850-475-4619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberME45689
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: