Provider Demographics
NPI:1306178025
Name:ROBERT P. D'AMICO D.O.P.A.
Entity Type:Organization
Organization Name:ROBERT P. D'AMICO D.O.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:D'AMICO
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:727-919-3911
Mailing Address - Street 1:2819 GREY OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34688-8159
Mailing Address - Country:US
Mailing Address - Phone:727-919-3911
Mailing Address - Fax:
Practice Address - Street 1:2819 GREY OAKS BLVD
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34688-8159
Practice Address - Country:US
Practice Address - Phone:727-919-3911
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS5533261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care