Provider Demographics
NPI:1730136292
Name:ROBINS, ROSS A (MD)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:A
Last Name:ROBINS
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:PO BOX 2699
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32513-2699
Mailing Address - Country:US
Mailing Address - Phone:850-475-4500
Mailing Address - Fax:850-475-4619
Practice Address - Street 1:13139 SORRENTO RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8777
Practice Address - Country:US
Practice Address - Phone:850-492-0543
Practice Address - Fax:850-492-6340
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-30
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME45689207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL040438100Medicaid
FLD53358Medicare UPIN
FL040438100Medicaid