Provider Demographics
NPI:1467404921
Name:PROIETTO, ROBERT L (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:PROIETTO
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1201 5TH AVE N
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1400
Mailing Address - Country:US
Mailing Address - Phone:727-822-5410
Mailing Address - Fax:941-746-4111
Practice Address - Street 1:1201 5TH AVE N
Practice Address - Street 2:SUITE 410
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1433
Practice Address - Country:US
Practice Address - Phone:727-822-5410
Practice Address - Fax:941-746-4111
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS 9127207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2736187-00Medicaid
FLP00246286OtherRR MCARE
FLP00246286OtherRR MCARE
FLI21698Medicare UPIN