Individual
ROBERT J BASTIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1874 SE PORT ST LUCIE BLVD, PORT ST LUCIE, FL 34952-5545
(772) 337-7676
(772) 337-9034
Mailing address
3225 SW BRAEMAR WAY, PORT SAINT LUCIE, FL 34952
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME77606
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050075157
RR MEDICARE
FL
05
—
256049600
—
FL
01
—
44956
BCBS OF FLORIDA
FL
Enumeration date
06/02/2006
Last updated
06/08/2011
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