Provider Demographics
NPI:1821569146
Name:CORVINO, ROBERT DOMINIC II (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DOMINIC
Last Name:CORVINO
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6019 SONGBIRD DR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-7067
Mailing Address - Country:US
Mailing Address - Phone:716-480-2350
Mailing Address - Fax:
Practice Address - Street 1:2464 S HIGHWAY 29
Practice Address - Street 2:
Practice Address - City:CANTONMENT
Practice Address - State:FL
Practice Address - Zip Code:32533-5808
Practice Address - Country:US
Practice Address - Phone:850-546-4640
Practice Address - Fax:833-695-8364
Is Sole Proprietor?:No
Enumeration Date:2018-12-14
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH12669111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor