Provider Demographics
NPI:1942373246
Name:ROBERT J CASANAS MD LLC
Entity Type:Organization
Organization Name:ROBERT J CASANAS MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERNAL MEDICINE PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASANAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:813-792-5730
Mailing Address - Street 1:9825 BAY ISLAND DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33615-4217
Mailing Address - Country:US
Mailing Address - Phone:813-792-5730
Mailing Address - Fax:813-792-5704
Practice Address - Street 1:9825 BAY ISLAND DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-4217
Practice Address - Country:US
Practice Address - Phone:813-792-5730
Practice Address - Fax:813-792-5704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME65487207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL57946OtherBCBS OF FL
E8754AOtherMEDICARE SUPPLIER