Provider Demographics
NPI:1932193307
Name:TOBIN, JANET M (MD PA)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:M
Last Name:TOBIN
Suffix:
Gender:F
Credentials:MD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 510867
Mailing Address - Street 2:
Mailing Address - City:PUNTA GORDA
Mailing Address - State:FL
Mailing Address - Zip Code:33951-0867
Mailing Address - Country:US
Mailing Address - Phone:941-629-3435
Mailing Address - Fax:941-629-5250
Practice Address - Street 1:2400 HARBOR BLVD
Practice Address - Street 2:STE 13
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33952-5052
Practice Address - Country:US
Practice Address - Phone:941-629-3435
Practice Address - Fax:941-629-5250
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME62883207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL18220OtherBCBS
FLF43158Medicare UPIN
FL18220OtherBCBS
FLP00157032Medicare ID - Type UnspecifiedRAILROAD MEDICARE
FLK6443Medicare ID - Type UnspecifiedGROUP NUMBER