Provider Demographics
NPI:1669440947
Name:URBAN, ROBERT C JR (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:C
Last Name:URBAN
Suffix:JR
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 1:5425 WATER ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4030
Mailing Address - Country:US
Mailing Address - Phone:727-807-7090
Mailing Address - Fax:727-807-7076
Practice Address - Street 1:5425 WATER ST
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4030
Practice Address - Country:US
Practice Address - Phone:727-807-7090
Practice Address - Fax:727-807-7076
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME63362207W00000X, 207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
18181OtherBCBS
FL371540000Medicaid
18181Medicare PIN
18181OtherBCBS