Provider Demographics
NPI:1922366608
Name:TREVIL, ROBINSON (DO)
Entity Type:Individual
Prefix:
First Name:ROBINSON
Middle Name:
Last Name:TREVIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MEMORIAL MEDICAL PKWY
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32117-5167
Mailing Address - Country:US
Mailing Address - Phone:434-799-3859
Mailing Address - Fax:
Practice Address - Street 1:1955 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4712
Practice Address - Country:US
Practice Address - Phone:434-799-2055
Practice Address - Fax:434-799-2044
Is Sole Proprietor?:No
Enumeration Date:2012-05-01
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0116024042207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine