Provider Demographics
NPI:1225647977
Name:SINGLETON, ROBERT DREW (MMS, PA-C)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:DREW
Last Name:SINGLETON
Suffix:
Gender:M
Credentials:MMS, PA-C
Other - Prefix:
Other - First Name:DREW
Other - Middle Name:
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MMS, PA-C
Mailing Address - Street 1:6905 N WICKHAM RD STE 205
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-7551
Mailing Address - Country:US
Mailing Address - Phone:321-234-5100
Mailing Address - Fax:
Practice Address - Street 1:6905 N WICKHAM RD STE 205
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-7551
Practice Address - Country:US
Practice Address - Phone:321-234-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9113233363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMS7266073OtherDEA