Provider Demographics
NPI:1528536349
Name:ROARKE, ROBIN (DOM AP RN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:ROARKE
Suffix:
Gender:F
Credentials:DOM AP RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:34223-2303
Mailing Address - Country:US
Mailing Address - Phone:941-525-2375
Mailing Address - Fax:
Practice Address - Street 1:1000 BAYSHORE DR
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:FL
Practice Address - Zip Code:34223-2303
Practice Address - Country:US
Practice Address - Phone:941-525-2375
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-09
Last Update Date:2018-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9312531163W00000X
FLAP4001171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No163W00000XNursing Service ProvidersRegistered Nurse