Provider Demographics
NPI:1699724914
Name:DIMASI, ROBERT E (DO)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:DIMASI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3870 TAMPA RD
Mailing Address - Street 2:SUITE D
Mailing Address - City:OLDSMAR
Mailing Address - State:FL
Mailing Address - Zip Code:34677-3120
Mailing Address - Country:US
Mailing Address - Phone:813-336-4949
Mailing Address - Fax:813-336-4946
Practice Address - Street 1:3870 TAMPA RD
Practice Address - Street 2:SUITE D
Practice Address - City:OLDSMAR
Practice Address - State:FL
Practice Address - Zip Code:34677
Practice Address - Country:US
Practice Address - Phone:813-336-4949
Practice Address - Fax:813-336-4946
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLOS6208207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL21762OtherBCBS
FLF07743Medicare UPIN
FL80555OMedicare PIN
FL21762OtherBCBS