Provider Demographics
NPI:1043414055
Name:CARRIE, ROBIN D (ARNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:D
Last Name:CARRIE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13833
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19101-3833
Mailing Address - Country:US
Mailing Address - Phone:352-265-0139
Mailing Address - Fax:352-627-4268
Practice Address - Street 1:1600 SW ARCHER ROAD
Practice Address - Street 2:M452
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0139
Practice Address - Fax:352-627-4268
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP827162363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL308584800Medicaid
FLAF657YMedicare PIN