Provider Demographics
NPI:1417118670
Name:ROBB WILENTZ MD PA
Entity Type:Organization
Organization Name:ROBB WILENTZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBB
Authorized Official - Middle Name:ELLIOT
Authorized Official - Last Name:WILENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-457-8115
Mailing Address - Street 1:2100 E HALLANDALE BEACH BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-3765
Mailing Address - Country:US
Mailing Address - Phone:954-457-8115
Mailing Address - Fax:
Practice Address - Street 1:2100 E HALLANDALE BEACH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:HALLANDALE BEACH
Practice Address - State:FL
Practice Address - Zip Code:33009-3765
Practice Address - Country:US
Practice Address - Phone:954-457-8115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty