Provider Demographics
NPI:1467632687
Name:TINSLEY, ROBERT W III (DPM)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:W
Last Name:TINSLEY
Suffix:III
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7341 OFFICE PARK PL
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VIERA
Mailing Address - State:FL
Mailing Address - Zip Code:32940-8280
Mailing Address - Country:US
Mailing Address - Phone:321-253-4973
Mailing Address - Fax:321-253-4913
Practice Address - Street 1:7341 OFFICE PARK PL
Practice Address - Street 2:SUITE 103
Practice Address - City:VIERA
Practice Address - State:FL
Practice Address - Zip Code:32940-8280
Practice Address - Country:US
Practice Address - Phone:321-253-4973
Practice Address - Fax:321-253-4913
Is Sole Proprietor?:No
Enumeration Date:2007-11-05
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPO1521213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLT55589Medicare UPIN