Provider Demographics
NPI:1669582474
Name:TOMSICK, ROBERT S (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:TOMSICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15051 S. TAMIAMI TRAIL
Mailing Address - Street 2:SUITE 203
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908
Mailing Address - Country:US
Mailing Address - Phone:239-437-8810
Mailing Address - Fax:239-313-2555
Practice Address - Street 1:261 9TH STREET SOUTH
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102
Practice Address - Country:US
Practice Address - Phone:239-216-4337
Practice Address - Fax:239-261-5594
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC22283207N00000X
FLME33970207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLME33970OtherFL MEDICAL LICENSE
NC8983634Medicaid
NC8983634Medicaid
NC211002BMedicare ID - Type Unspecified