Provider Demographics
NPI:1154333573
Name:ROBERT W. TINSLEY, DPM,PA
Entity Type:Organization
Organization Name:ROBERT W. TINSLEY, DPM,PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:TINSLEY
Authorized Official - Suffix:III
Authorized Official - Credentials:DPM
Authorized Official - Phone:321-253-4973
Mailing Address - Street 1:7341 OFFICE PARK PL
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8280
Mailing Address - Country:US
Mailing Address - Phone:321-253-4973
Mailing Address - Fax:321-253-4913
Practice Address - Street 1:7341 OFFICE PARK PL
Practice Address - Street 2:SUITE 103
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-8280
Practice Address - Country:US
Practice Address - Phone:321-253-4973
Practice Address - Fax:321-253-4913
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO1521213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1154333573OtherNPI NUMBER
FL1154333573OtherNPI NUMBER
FL0547850001Medicare NSC
FL87892Medicare ID - Type Unspecified