Provider Demographics
NPI:1679681845
Name:ROBINSON, LONNIE BRIAN (DPM)
Entity Type:Individual
Prefix:
First Name:LONNIE
Middle Name:BRIAN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:L
Other - Middle Name:BRIAN
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM PA
Mailing Address - Street 1:1355 37TH ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-7321
Mailing Address - Country:US
Mailing Address - Phone:772-231-6000
Mailing Address - Fax:772-231-6010
Practice Address - Street 1:1355 37TH ST
Practice Address - Street 2:SUITE 402
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-7321
Practice Address - Country:US
Practice Address - Phone:772-231-6000
Practice Address - Fax:772-231-6010
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2009-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLP02601213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U57175Medicare UPIN