MEDICARE: DR. RUSSELL L. ROBINSON MD

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	207R00000X	Internal Medicine Physician	ME115188	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003999715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RUSSELL L. ROBINSON MD

Provider Business Mailing Address
First Line	:	1926 VICTORIA AVE
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33901-3414
Country	:	US
Telephone Number	:	239-344-3291
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 DEL PRADO BLVD S
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33990-1710
Country	:	US
Telephone Number	:	239-314-1616
Fax Number	:	239-479-5202

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	04/19/2024

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