Provider Demographics
NPI:1457317489
Name:LAW, ROBERT K (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:K
Last Name:LAW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3151 N ALAFAYA TRL
Mailing Address - Street 2:101
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-2945
Mailing Address - Country:US
Mailing Address - Phone:407-207-5000
Mailing Address - Fax:407-207-8920
Practice Address - Street 1:3151 N ALAFAYA TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-2945
Practice Address - Country:US
Practice Address - Phone:407-207-5000
Practice Address - Fax:407-207-8920
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2009-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLFLOS6107207Q00000X, 207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL252743000Medicaid
FL80559Medicare PIN
FL252743000Medicaid
FL80559XMedicare PIN