Provider Demographics
NPI:1528168770
Name:WILKINS, ROBERT TERRELL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:TERRELL
Last Name:WILKINS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:13961 LONG LAKE LN
Mailing Address - Street 2:
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33953-5675
Mailing Address - Country:US
Mailing Address - Phone:941-613-1911
Mailing Address - Fax:941-235-2712
Practice Address - Street 1:5100 W KENNEDY BLVD STE 160
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-1817
Practice Address - Country:US
Practice Address - Phone:813-935-4145
Practice Address - Fax:813-935-0550
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2019-08-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME 970632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry