Individual
ROBERT T LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
455 W WARREN AVE, LONGWOOD, FL 32750-4038
(407) 262-2220
(407) 834-5011
Mailing address
455 W WARREN AVE, LONGWOOD, FL 32750-4038
(407) 262-2220
(407) 834-5011
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
0101233539
VA
2084P0800X
Psychiatry Physician
Primary
ME166560
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010004586
—
VA
05
—
121445800
—
FL
01
—
136804
ANTHEM BC
VA
Enumeration date
11/29/2005
Last updated
03/18/2024
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