Provider Demographics
NPI:1861905598
Name:TEE, ROBERT CHARLES
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHARLES
Last Name:TEE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 18TH ST APT 3
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32960-5575
Mailing Address - Country:US
Mailing Address - Phone:772-563-7915
Mailing Address - Fax:
Practice Address - Street 1:15100 HUTCHISON RD STE 121
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33625-5512
Practice Address - Country:US
Practice Address - Phone:813-557-3533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-16
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL106500000XMedicaid