Provider Demographics
NPI:1851398143
Name:VANFLEET, ROBERT HAWKINS (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:HAWKINS
Last Name:VANFLEET
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 1:7214 WAREHAM DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-1166
Mailing Address - Country:US
Mailing Address - Phone:813-972-9456
Mailing Address - Fax:
Practice Address - Street 1:7214 WAREHAM DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-1166
Practice Address - Country:US
Practice Address - Phone:813-972-9456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-01
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG1471362085R0202X
FLME573902085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL058624200Medicaid
F17674Medicare UPIN
FL058624200Medicaid