Provider Demographics
NPI:1649363763
Name:JENSEN, ROBERT P (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:P
Last Name:JENSEN
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:PO BOX 30532
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32503-1532
Mailing Address - Country:US
Mailing Address - Phone:850-916-3700
Mailing Address - Fax:850-916-8666
Practice Address - Street 1:1040 GULF BREEZE PKWY
Practice Address - Street 2:ANDREWS INSTITUTE
Practice Address - City:GULF BREEZE
Practice Address - State:FL
Practice Address - Zip Code:32561-7809
Practice Address - Country:US
Practice Address - Phone:850-916-3700
Practice Address - Fax:850-916-8666
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83208174400000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL59178338OtherBCBS ALABAMA
AL115644Medicaid
AL59181065OtherBCBS ALABAMA - IRC/PMR
P00810290OtherMEDICARE RAILROAD
FL2176326OtherUNITED HEALTHCARE
FL06010OtherBCBS FLORIDA
FL262893700Medicaid
AL59185879OtherBCBS ALABAMA - GBO
AL592-10093OtherBLUE CROSS BLUE SHIELD
7889320OtherAETNA
FLB790OtherHEALTH FIRST
FLP00265832OtherMEDICARE RAILROAD
AL59178338OtherBCBS ALABAMA
AL59181065OtherBCBS ALABAMA - IRC/PMR
FL262893700Medicaid
AL115644Medicaid
FLP00265832OtherMEDICARE RAILROAD