Physician Compare National (NPI:1629184106)

HEALTHCARE PROVIDER: RENA MICHEL ROBBINS M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1629184106
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507999745
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100809000585
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROBBINS
	Individual professional last name
Provider First Name	RENA
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NY UPSTATE MEDICAL UNIVERSITY
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	621 S NOVA RD
	Group Practice or individual's line 1 address
City	ORMOND BEACH
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	321746901
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3866770005
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100068
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FLORIDA HOSPITAL MEMORIAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100017
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HALIFAX HEALTH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y