Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003070426 |
---|---|
Provider Name | Randy E Robinson |
First Address | Tampa, FL 33610-4350 |
Second Address | Tampa, FL 33610-4350 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 15/07/2008 |