Active NPI
Robenson Forestal
- Medical Physician Assistant
- Sarasota, FL
National Provider Identifier
1326619057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 869PA
- Practice address
- 4617 Summer Oak Ave E Apt 818
Sarasota, FL 34243-4984 - Phone
- (561) 657-5256
- NPI assigned
- Jul 4, 2021
- Last updated
- Jul 4, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 869PA | PR | Primary |
Addresses
Primary practice location
4617 Summer Oak Ave E Apt 818
Sarasota, FL 34243-4984
Mailing address
4617 Summer Oak Ave E Apt 818
Sarasota, FL 34243-4984
Phone (561) 657-5256
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 869PA | PR | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1625356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1625356800000",
"number": "1326619057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4617 SUMMER OAK AVE E APT 818",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342434984",
"telephone_number": "561-657-5256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4617 SUMMER OAK AVE E APT 818",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342434984",
"telephone_number": "561-657-5256"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORESTAL",
"first_name": "ROBENSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-04",
"last_updated": "2021-07-04",
"certification_date": "2021-07-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "PR",
"license": "869PA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.