Provider Demographics
NPI:1184604480
Name:ROBINSON, LAWRENCE GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:GEORGE
Last Name:ROBINSON
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 1:830 EXECUTIVE LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:ROCKLEDGE
Mailing Address - State:FL
Mailing Address - Zip Code:32955-3595
Mailing Address - Country:US
Mailing Address - Phone:321-639-2551
Mailing Address - Fax:321-504-6260
Practice Address - Street 1:830 EXECUTIVE LN
Practice Address - Street 2:SUITE 120
Practice Address - City:ROCKLEDGE
Practice Address - State:FL
Practice Address - Zip Code:32955-3595
Practice Address - Country:US
Practice Address - Phone:321-639-2551
Practice Address - Fax:321-504-6260
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-20
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME0057471207XP3100X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4593924OtherAETNA PPO
FL25967OtherBLUE CROSS BLUE SHIELD
FL27928OtherHEALTHEASE/STAYWELL
FL1727215001OtherCIGNA
FL377437600Medicaid
FL625781OtherAETNA HMO
FL1727215001OtherCIGNA
FL25967OtherBLUE CROSS BLUE SHIELD
FL200030851Medicare PIN