Provider Demographics
NPI:1679590178
Name:BIANCO, ROBERT CHRISTOPHER (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CHRISTOPHER
Last Name:BIANCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:14 OFFICE PARK DR
Mailing Address - Street 2:SUITE 1
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32137-3864
Mailing Address - Country:US
Mailing Address - Phone:386-446-2305
Mailing Address - Fax:386-446-1043
Practice Address - Street 1:14 OFFICE PARK DRIVE
Practice Address - Street 2:SUITE 1
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32137
Practice Address - Country:US
Practice Address - Phone:386-446-2305
Practice Address - Fax:386-446-1043
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-03-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME0057906207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005086OtherFLORIDA HEALTH CARE
FL10569OtherBCBS OF FLORIDA
FL063691600Medicaid
FL063691600Medicaid
E60659Medicare UPIN