Provider Demographics
NPI:1780657817
Name:ROBAINA, AL WILLIAM (MD)
Entity Type:Individual
Prefix:
First Name:AL
Middle Name:WILLIAM
Last Name:ROBAINA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ROBAINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5998 N US HIGHWAY 41 STE A
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572-3133
Mailing Address - Country:US
Mailing Address - Phone:813-751-3570
Mailing Address - Fax:813-641-9001
Practice Address - Street 1:5998 N US HIGHWAY 41 STE A
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572-3133
Practice Address - Country:US
Practice Address - Phone:813-751-3570
Practice Address - Fax:813-641-9001
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67245207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL26340SOtherMEDICARE ID-TYPE UNSPECIFIED
FL26340OtherMEDICARE ID
FL007348900Medicaid
G01983Medicare UPIN
FL26340SOtherMEDICARE ID-TYPE UNSPECIFIED