Provider Demographics
NPI:1134733082
Name:STEWART, ROBIN ROLLENA
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ROLLENA
Last Name:STEWART
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:ROLLENA
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9537 LAZY LN APT 302
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-1626
Mailing Address - Country:US
Mailing Address - Phone:813-924-7933
Mailing Address - Fax:
Practice Address - Street 1:9537 LAZY LANE
Practice Address - Street 2:APT 302
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614
Practice Address - Country:US
Practice Address - Phone:813-460-4273
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-08
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL236870251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health