Provider Demographics
NPI:1578581112
Name:MIDENCE, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:MIDENCE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3425 S HIGHLANDS AVE
Mailing Address - Street 2:
Mailing Address - City:SEBRING
Mailing Address - State:FL
Mailing Address - Zip Code:33870-5408
Mailing Address - Country:US
Mailing Address - Phone:863-471-9000
Mailing Address - Fax:863-382-2300
Practice Address - Street 1:3700 EMERGENCY LN
Practice Address - Street 2:
Practice Address - City:SEBRING
Practice Address - State:FL
Practice Address - Zip Code:33870-5536
Practice Address - Country:US
Practice Address - Phone:863-386-4302
Practice Address - Fax:863-382-3928
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2022-02-10
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Provider Licenses
StateLicense IDTaxonomies
FLME60055207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277365100Medicaid
FLP00446213OtherRAILROAD MEDICARE
FL12584OtherBCBS
FL12584YMedicare UPIN