Provider Demographics
NPI:1265858674
Name:BIELITZ, ROBERT (LHMC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:BIELITZ
Suffix:
Gender:M
Credentials:LHMC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3024
Mailing Address - Country:US
Mailing Address - Phone:631-671-9431
Mailing Address - Fax:
Practice Address - Street 1:7702 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3024
Practice Address - Country:US
Practice Address - Phone:727-847-0069
Practice Address - Fax:727-849-3780
Is Sole Proprietor?:No
Enumeration Date:2014-03-10
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14203101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL029556600Medicaid