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Dr. Robert Leonard Andino

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NPI Number Detailed Information

Provider Information:

Name: Dr. Robert Leonard Andino
Gender: M
Provider License Number If Given: 38009900

NPI Information:

NPI: 1871588301
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 7/18/2008

Provider Business Mailing Address:

Address: 1007 W RIVERSIDE BLVD
Rockford, IL 61103
Phone Number: 8158775575
Fax Number: 8158775550

Provider Business Practice Location Address:

Address: 1007 W RIVERSIDE BLVD
Rockford, IL 61103
Phone Number: 8158775575
Fax Number: 8158775550

Provider Taxonomy:

Primary: 111N00000X
Secondary (if any):
State: IL

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