Provider Demographics
NPI:1063534527
Name:FLORIN, ROBERT A (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:FLORIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 WATERMAN ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3116
Mailing Address - Country:US
Mailing Address - Phone:401-351-3030
Mailing Address - Fax:
Practice Address - Street 1:154 WATERMAN ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-3116
Practice Address - Country:US
Practice Address - Phone:401-351-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD051772084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0000ZFY289OtherBLUE CROSS MA - MEDEX
RI0000000508 001OtherBLUE CROSS BLUE SHIELD RI
RI0000000508 001OtherBLUE CROSS BLUE SHIELD RI