Provider Demographics
NPI:1710369020
Name:ROBERT N. BASKIN, MD, P.A.
Entity Type:Organization
Organization Name:ROBERT N. BASKIN, MD, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEWTON
Authorized Official - Last Name:BASKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-763-5337
Mailing Address - Street 1:2108 N GOLFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PLANT CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33566-6768
Mailing Address - Country:US
Mailing Address - Phone:813-763-5337
Mailing Address - Fax:
Practice Address - Street 1:2108 N GOLFVIEW DR
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33566-6768
Practice Address - Country:US
Practice Address - Phone:813-763-5337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME355305207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03943350Medicaid
FL30277YMedicare PIN
FLD53921Medicare UPIN