Provider Demographics
NPI:1912249962
Name:VIVIANO, ROBERT ANTHONY (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ANTHONY
Last Name:VIVIANO
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 1:3301 NE 1ST AVE APT 2515
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-4283
Mailing Address - Country:US
Mailing Address - Phone:845-702-2464
Mailing Address - Fax:
Practice Address - Street 1:8201 W BROWARD BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2701
Practice Address - Country:US
Practice Address - Phone:954-396-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-17
Last Update Date:2018-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS14359207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine