Provider Demographics
NPI:1881037109
Name:CONSTANTINE, ROBERT LOUIS JR (OTR/L)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOUIS
Last Name:CONSTANTINE
Suffix:JR
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3932 N 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-2807
Mailing Address - Country:US
Mailing Address - Phone:850-434-7755
Mailing Address - Fax:850-469-0858
Practice Address - Street 1:916 E FAIRFIELD DR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32503-2817
Practice Address - Country:US
Practice Address - Phone:850-434-7755
Practice Address - Fax:850-469-0858
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT8329225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ04X8OtherFLORIDA BLUE
FLHD274YMedicare PIN