ROBERT LAWRENCE LONG (NPI# 1356317002) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356317002 |
| Entity Type | Individual |
| Full Name | ROBERT LAWRENCE LONG |
| Credential | M.D. |
| Practice Address |
909 Mar Walt Dr Suite 1011 Fort Walton Beach FL 32547-6635 |
| Mailing Address |
2234 Colonial Blvd Managed Care Dept Fort Myers FL 33907-1412 |
| Practice Telephone | 8508633377 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2016-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | ME0043999 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | AVMED | 382563 | 01 |
| FL | RR MEDICARE | P00728665 | 01 |
| FL | WELLCARE | 1193377 | 01 |
| FL | BCBS OF FL | 47173 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407482672 | Robert Long | Case Management | 320 S Ridge Rd, Silver City, NM 88061-6610 | 2020-03-19 |
| 1013342591 | Robert Glendon Long | Pediatrics | 15 Woodpine Ct, Columbia, SC 29212 | 2013-09-04 |
| 1992148720 | Robert James Long | Student in an Organized Health Care Education/Training Program | 34800 Bob, San Diego, CA 92134-0001 | 2013-04-11 |
| 1780953380 | Robert Long | Emergency Medicine | 6016 Driftwood Ave, Ras Tanura, EASTERN PROVINCE 31311 | 2011-12-28 |
| 1437332160 | Robert Earl Long Sr. | Dentist | 527 Desoto Ave, Clarksdale, MS 38614-5216 | 2007-12-17 |
| 1326257486 | Robert Allen Long | Physical Therapist | 6250 Commercial St N.e., Salem, OR 97306 | 2007-05-22 |
| 1588877500 | Robert Michael Long | Dentist | 4359 Kukui Grove St, #104, Lihue, HI 96766-2008 | 2007-05-07 |
| 1508908880 | Robert Wayne Long | Specialist | 10215 214th Ave E, Bonney Lake, WA 98391-3909 | 2007-02-13 |
| 1194861328 | Robert W Long | Technician/Technologist | 240 Commonwealth Blvd W Ste 108, Martinsville, VA 24112-1841 | 2007-01-29 |
| 1649283334 | Robert Gene Long | Contractor | 1899 -116th Ave Ne, Bellevue, WA 98004 | 2006-08-14 |
| Street Address |
909 MAR WALT DR SUITE 1011 |
| City | FORT WALTON BEACH |
| State | FL |
| Zip Code | 32547-6635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174768477 | Genesiscare Usa of Florida LLC | Urology | 909 Mar Walt Dr, Suite 1011, Fort Walton Beach, FL 32547-6635 | 2008-12-16 |
| 1891729026 | Emerald Coast Urology | Urology | 909 Mar Walt Dr, Suite 1011, Fort Walton Beach, FL 32547-6635 | 2006-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255944955 | Theresa Ann Morvay | Behavior Technician | 419 Racetrack Rd Ne, Fort Walton Beach, FL 32547 | 2020-08-24 |
| 1588295422 | Emily Ann Glossop | Nurse Practitioner | 930 Mar Walt Drive C, Fort Walton Beach, FL 32547 | 2020-01-29 |
| 1225669443 | Elizabeth Rogers Nagengast | Physician Assistant | 930 Mar Walt Drive, Unit C, Fort Walton Beach, FL 32547 | 2020-01-27 |
| 1497254791 | Carmen Alston | Nurse Practitioner | 930 Mar Walt Dr C, Fort Walton Beach, FL 32547 | 2018-02-02 |
| 1871004960 | Center for Neuropsychological Services Cns | Clinical Neuropsychologist | 1817 Lewis Turner Blvd, Fort Walton Beach, FL 32547 | 2017-10-17 |
| 1194235648 | Robin Wray | Speech-Language Pathologist | 930 Mar Walt Dr D, Fort Walton Beach, FL 32547 | 2017-10-10 |
| 1285007989 | Dynamic Pain & Wellness Pllc | Pain Medicine | 930 Marwalt Drive, Suite B and C, Fort Walton Beach, FL 32547 | 2015-11-04 |
| 1013392810 | Terry Abbott | Social Worker | 648 Overbrook Dr, Fort Walton Beach, FL 32547 | 2015-07-22 |
| 1083024673 | Emily Lohr | Physical Therapy Assistant | 2000 Principle Ln, Ft. Walton Beach, FL 32547 | 2014-05-05 |
| 1831526102 | Laurie Ann Schweppe | Nurse Practitioner | 1005 Mar Walt Drivve, Snf Hospitalist Department, Fort Walton Beach, FL 32547 | 2013-10-02 |
| Find all providers in zip 32547 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598975641 | Christopher L Allam | Urology | 341 Racetrack Rd Nw, Suite B, Fort Walton Beach, FL 32547-1552 | 2007-05-23 |
| 1205804432 | Okaloosa Walton Urology Pa | Urology | 1112 Hospital Rd, Unit A, Fort Walton Beach, FL 32547-6655 | 2006-03-14 |
| 1306234174 | 21st Century Oncology LLC | Urology | 914b Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2015-01-02 |
| 1427339399 | Genesiscare Usa of Florida LLC | Urology | 914 Mar Walt Dr, Suite B, Fort Walton Beach, FL 32547-6706 | 2011-09-06 |
| 1144519018 | Beibei Oelrich | Urology | 1032 Mar Walt Dr Unit 250, Fort Walton Beach, FL 32547 | 2011-03-31 |
| 1174768477 | Genesiscare Usa of Florida LLC | Urology | 909 Mar Walt Dr, Suite 1011, Fort Walton Beach, FL 32547-6635 | 2008-12-16 |
| 1235326026 | Basil D. Fossum, M.d.,f.a.c.s | Urology | 914b Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2007-09-26 |
| 1891729026 | Emerald Coast Urology | Urology | 909 Mar Walt Dr, Suite 1011, Fort Walton Beach, FL 32547-6635 | 2006-07-11 |
| 1851331474 | John R Burns | Urology | 914b Mar Walt Dr, Fort Walton Beach, FL 32547-6706 | 2006-06-08 |
| 1013957240 | William F Stiles IIi | Urology | 1032 Mar Walt Drive, Suite 250, Fort Walton Beach, FL 32547 | 2006-06-07 |
| Find all providers in FORT WALTON BEACH | ||||
| City | FORT WALTON BEACH |
| Zip Code | 32547 |
Please comment or provide details below to improve the information on ROBERT LAWRENCE LONG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.