Provider Demographics
NPI:1619799608
Name:ROBINSON, SHAUNTE (LPN)
Entity type:Individual
Prefix:
First Name:SHAUNTE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4116 N PINE ISLAND RD.
Mailing Address - Street 2:APT. 133
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33351
Mailing Address - Country:US
Mailing Address - Phone:954-728-0158
Mailing Address - Fax:
Practice Address - Street 1:4116 N PINE ISLAND RD.
Practice Address - Street 2:APT. 133
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351
Practice Address - Country:US
Practice Address - Phone:954-728-0158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPN5255451164W00000X
FLPN5255451164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse