Provider Demographics
NPI:1477541639
Name:SAMBURSKY, ROBERT PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PAUL
Last Name:SAMBURSKY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 MANATEE AVE E
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34208-1931
Mailing Address - Country:US
Mailing Address - Phone:941-748-1818
Mailing Address - Fax:941-746-1055
Practice Address - Street 1:217 MANATEE AVE E
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34208-1931
Practice Address - Country:US
Practice Address - Phone:941-748-1818
Practice Address - Fax:941-746-1055
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2013-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0092802207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL272441300Medicaid
FL272441300Medicaid
FL03460ZMedicare PIN