Healthcare Provider Details

I. General information

NPI: 1275515215
Provider Name (Legal Business Name): ROBIN ROY HUGHES III MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2919 W SWANN AVE SUITE 402
TAMPA FL
33609-4038
US

IV. Provider business mailing address

2919 W SWANN AVE SUITE 402
TAMPA FL
33609-4038
US

V. Phone/Fax

Practice location:
  • Phone: 813-414-9400
  • Fax: 813-414-9401
Mailing address:
  • Phone: 813-414-9400
  • Fax: 813-414-9401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberME0058198
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: