Provider Demographics
NPI:1326174145
Name:BALKIN, ROBYN TRACY (PA)
Entity Type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:TRACY
Last Name:BALKIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:8787 BRYAN DAIRY RD
Mailing Address - Street 2:#360
Mailing Address - City:LARGO
Mailing Address - State:FL
Mailing Address - Zip Code:33777-1251
Mailing Address - Country:US
Mailing Address - Phone:727-393-4900
Mailing Address - Fax:727-393-4910
Practice Address - Street 1:8787 BRYAN DAIRY RD
Practice Address - Street 2:#360
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33777-1251
Practice Address - Country:US
Practice Address - Phone:727-393-4900
Practice Address - Fax:727-393-4910
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9101880363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP61276Medicare UPIN
FLE7566ZMedicare ID - Type Unspecified