MEDICARE: ROBERT STEPHEN ADCOCK MSSW

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	1041C0700X	Clinical Social Worker	SW 5409	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FL1429	OTHER	FL	BRADMAN NETWORK
2	198686	OTHER	FL	COMPSYCH
3	2074595	OTHER	FL	CIGNA BEHAVIORAL
4	7532382	OTHER	FL	AETNA BEHAVIORAL

General Provider Information

NPI Number	:	1316034614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT STEPHEN ADCOCK MSSW

Provider Business Mailing Address
First Line	:	PO BOX 320331
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33679-2331
Country	:	US
Telephone Number	:	813-335-5444
Fax Number	:	727-576-0651

Provider Business Practice Location Address
First Line	:	200 S HOOVER BLVD
Second Line	:	SUITE 170
City	:	TAMPA
State	:	FL
Zip	:	33609-3540
Country	:	US
Telephone Number	:	813-335-5444
Fax Number	:	727-576-0651

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

Provider Enumeration Date	:	10/06/2006
Last Update Date	:	07/08/2007

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