Provider Demographics
NPI:1376849018
Name:ROBERT ANTOINE MD PA
Entity Type:Organization
Organization Name:ROBERT ANTOINE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTOINE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-410-0403
Mailing Address - Street 1:2501 E COMMERCIAL BLVD
Mailing Address - Street 2:STE 211
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-4131
Mailing Address - Country:US
Mailing Address - Phone:516-410-0403
Mailing Address - Fax:
Practice Address - Street 1:2501 E COMMERCIAL BLVD
Practice Address - Street 2:STE 211
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-4131
Practice Address - Country:US
Practice Address - Phone:516-410-0403
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty