Provider Demographics
NPI:1518916279
Name:ROBISON, THOMAS J (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:ROBISON
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 1:560 JACKSON ST N STE 302
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33705-1449
Mailing Address - Country:US
Mailing Address - Phone:727-895-9640
Mailing Address - Fax:727-895-9692
Practice Address - Street 1:560 JACKSON ST N STE 302
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33705-1449
Practice Address - Country:US
Practice Address - Phone:727-895-9640
Practice Address - Fax:727-895-9692
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME54156207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279362800Medicaid
FLP00443859OtherRAILROAD MEDICARE NUMBER
FL14537XMedicare PIN
FLP00443859OtherRAILROAD MEDICARE NUMBER