Provider Demographics
NPI:1376711622
Name:LAWRENCE G ROBINSON MD PA
Entity Type:Organization
Organization Name:LAWRENCE G ROBINSON MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:321-639-2551
Mailing Address - Street 1:830 EXECUTIVE LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3595
Mailing Address - Country:US
Mailing Address - Phone:321-639-2551
Mailing Address - Fax:321-504-6260
Practice Address - Street 1:830 EXECUTIVE LN
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3595
Practice Address - Country:US
Practice Address - Phone:321-639-2551
Practice Address - Fax:321-504-6260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057471207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLBD423Medicare PIN
FL1311320001Medicare NSC