Provider Demographics
NPI:1669469631
Name:HUBBARD, ROBERT FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:FRANCIS
Last Name:HUBBARD
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:P.O. BOX 2147
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33902-2147
Mailing Address - Country:US
Mailing Address - Phone:239-343-9470
Mailing Address - Fax:239-343-9498
Practice Address - Street 1:8960 COLONIAL CENTER DRIVE
Practice Address - Street 2:SUITE 300
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905-7810
Practice Address - Country:US
Practice Address - Phone:239-343-9470
Practice Address - Fax:239-343-9498
Is Sole Proprietor?:No
Enumeration Date:2005-10-04
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036068580207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017302400Medicaid
IL2220936OtherBCBS
IL036068580 1Medicaid
D15522Medicare UPIN
ILL37948Medicare PIN