Connolly, Robin John

Connolly, Robin John is an individual health care provider with primary practice located at 1825 Se Tiffany Ave Suite 104, Port St Lucie FL 34952-7554. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Connolly, Robin John can be contacted via phone (772) 398-2233.

Contact Information

Primary practice address
1825 Se Tiffany Ave Suite 104 Port St Lucie FL 34952-7554
Phone: (772) 398-2233
Fax: (772) 398-2244
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X ME57428 Florida

Profile Details

NPI number 1740226026
LBN Legal business name Connolly, Robin John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 22nd, 2006
Last updated Sep 13th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1740226026 NPPES
Florida MEDICAID 051223100
Florida Other 11634

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