Provider Demographics
NPI:1629036249
Name:ROBINSON, BRUCE E (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:E
Last Name:ROBINSON
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:PO BOX 863407
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32886-3407
Mailing Address - Country:US
Mailing Address - Phone:941-917-2600
Mailing Address - Fax:941-917-7884
Practice Address - Street 1:1515 S OSPREY AVE
Practice Address - Street 2:SUITE 1-A
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2939
Practice Address - Country:US
Practice Address - Phone:941-917-7197
Practice Address - Fax:941-917-4016
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34745207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065977100Medicaid
FL30424OtherBCBS
FLD53984Medicare UPIN
FL30424OtherBCBS