Provider Demographics
NPI:1003459637
Name:ROBINSON, JEROME ANTONIO JR
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:ANTONIO
Last Name:ROBINSON
Suffix:JR
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 1:2212 BLASS DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29505-6479
Mailing Address - Country:US
Mailing Address - Phone:843-453-1917
Mailing Address - Fax:
Practice Address - Street 1:2212 BLASS DR
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29505-6479
Practice Address - Country:US
Practice Address - Phone:843-453-1917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-27
Last Update Date:2019-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health