Provider Demographics
NPI:1730391988
Name:EID, ROBERT ELLIS (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ELLIS
Last Name:EID
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:P.O.BOX 2880
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33045-2880
Mailing Address - Country:US
Mailing Address - Phone:305-293-3557
Mailing Address - Fax:305-293-9983
Practice Address - Street 1:LOWER KEYS MEDICAL CENTER
Practice Address - Street 2:5900 COLLEGE RD
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040
Practice Address - Country:US
Practice Address - Phone:305-294-3351
Practice Address - Fax:305-293-9983
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 38704207L00000X
ORMD24816207L00000X
TNMD0000037800207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL065787500Medicaid
FL065787500Medicaid
FLD54470Medicare UPIN