MEDICARE: ROBERT LAWRENCE LONG M.D.

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	208800000X	Urology Physician	ME0043999	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00728665	OTHER	FL	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1193377	OTHER	FL	WELLCARE
2	382563	OTHER	FL	AVMED
3	47173	OTHER	FL	BCBS OF FL

General Provider Information

NPI Number	:	1356317002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT LAWRENCE LONG M.D.

Provider Business Mailing Address
First Line	:	2234 COLONIAL BLVD
Second Line	:	MANAGED CARE DEPT
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1412
Country	:	US
Telephone Number	:	239-931-7342
Fax Number	:	239-931-7385

Provider Business Practice Location Address
First Line	:	909 MAR WALT DR
Second Line	:	SUITE 1011
City	:	FORT WALTON BEACH
State	:	FL
Zip	:	32547-6635
Country	:	US
Telephone Number	:	850-863-3377
Fax Number	:

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

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	12/08/2016

Similar Medicare Providers

1891729026 — EMERALD COAST UROLOGY
Practice Location Address:

909 MAR WALT DR , SUITE 1011
FORT WALTON BEACH, FL
32547-6635

Practice Phone: 850-863-3377
Practice Fax:

1174768477 — GENESISCARE USA OF FLORIDA LLC
Practice Location Address:

909 MAR WALT DR , SUITE 1011
FORT WALTON BEACH, FL
32547-6635

Practice Phone: 850-683-3377
Practice Fax:

1982074720 — MONTGOMERY VAMC
Practice Location Address:

6635 BASS RD BLDG 9214
FORT MOORE, GA
31905-5602

Practice Phone: 828-257-2333
Practice Fax:

1669090130 — MR. QUASHON ADAIRE JOHNSON SR. LCSW
Practice Location Address:

6635 BASS RD BLDG 92145
FORT BENNING, GA
31905-5602

Practice Phone: 706-257-7205
Practice Fax: 706-626-0827

1821668609 — EOLANDE BRIANNE HILL
Practice Location Address:

6635 FORT KING RD APT 111
ZEPHYRHILLS, FL
33542-4847

Practice Phone: 813-602-3844
Practice Fax:

1720658347 — IREANNA BER'SCHIRRA MORRALL RN
Practice Location Address:

6635 BASS RD BLDG 9214
FORT BENNING, GA
31905-5602

Practice Phone: 706-257-7200
Practice Fax:

Directions to “ ROBERT LAWRENCE LONG M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.