Provider Demographics
NPI:1811121452
Name:ROBERT EID MDPA
Entity type:Organization
Organization Name:ROBERT EID MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:EID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-293-3557
Mailing Address - Street 1:PO BOX 2880
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33045-2880
Mailing Address - Country:US
Mailing Address - Phone:305-293-3557
Mailing Address - Fax:305-293-9983
Practice Address - Street 1:5900 COLLEGE RD
Practice Address - Street 2:C/O OPERATING ROOM
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4342
Practice Address - Country:US
Practice Address - Phone:305-294-5531
Practice Address - Fax:305-292-9196
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-11
Last Update Date:2009-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME38704207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL36309OtherBLUE CROSS
FL065787500Medicaid
FL36309Medicare PIN