Provider Demographics
NPI:1629157656
Name:HOPKINS, ROBERT J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36181 E LAKE RD # 390
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3142
Mailing Address - Country:US
Mailing Address - Phone:727-781-8685
Mailing Address - Fax:727-786-2852
Practice Address - Street 1:36181 E LAKE RD # 390
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-3142
Practice Address - Country:US
Practice Address - Phone:727-781-8685
Practice Address - Fax:727-786-2852
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA2614363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL290125100Medicaid
FL970005300OtherRAILROAD M-CARE PROVIDER#
FLE5489VMedicare PIN
FLS57795Medicare UPIN
FL970005300OtherRAILROAD M-CARE PROVIDER#