Provider Demographics
NPI:1427323351
Name:NANCY L ROBBIN, M.D. PA
Entity type:Organization
Organization Name:NANCY L ROBBIN, M.D. PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:L
Authorized Official - Last Name:ROBBIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-797-4211
Mailing Address - Street 1:2555 ENTERPRISE RD STE 9-3
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1150
Mailing Address - Country:US
Mailing Address - Phone:727-797-4211
Mailing Address - Fax:813-354-2443
Practice Address - Street 1:2555 ENTERPRISE RD STE 9-3
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1150
Practice Address - Country:US
Practice Address - Phone:727-797-4211
Practice Address - Fax:813-354-2443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-10
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16405207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty