Provider Demographics
NPI:1932355484
Name:ROBERT K LAW DO PA
Entity Type:Organization
Organization Name:ROBERT K LAW DO PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:K
Authorized Official - Last Name:LAW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:407-207-5000
Mailing Address - Street 1:P.O. BOX 2015
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765
Mailing Address - Country:US
Mailing Address - Phone:407-207-5000
Mailing Address - Fax:407-207-8920
Practice Address - Street 1:3151 N ALAFAYA TRL
Practice Address - Street 2:SUITE 101
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-2945
Practice Address - Country:US
Practice Address - Phone:407-207-5000
Practice Address - Fax:407-207-8920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-15
Last Update Date:2010-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277818100Medicaid
FL98418OtherBCBS
FL98418OtherBCBS