Provider Demographics
NPI:1588609093
Name:HOLSTEIN, ROBERT B (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:B
Last Name:HOLSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 S OSCEOLA AVE
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:FL
Mailing Address - Zip Code:34452-4727
Mailing Address - Country:US
Mailing Address - Phone:352-726-5533
Mailing Address - Fax:352-726-5818
Practice Address - Street 1:101 S OSCEOLA AVE
Practice Address - Street 2:
Practice Address - City:INVERNESS
Practice Address - State:FL
Practice Address - Zip Code:34452-4727
Practice Address - Country:US
Practice Address - Phone:352-726-5533
Practice Address - Fax:352-726-5818
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS 0004629207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD27377Medicare UPIN
FL82588XMedicare PIN