Provider Demographics
NPI:1053860114
Name:TERI ROBIOU LLC
Entity Type:Organization
Organization Name:TERI ROBIOU LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBIOU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-788-9928
Mailing Address - Street 1:1450 MADRUGA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-3164
Mailing Address - Country:US
Mailing Address - Phone:305-788-9928
Mailing Address - Fax:
Practice Address - Street 1:1450 MADRUGA AVE STE 300
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-3164
Practice Address - Country:US
Practice Address - Phone:305-788-9928
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-29
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
FLPY8108314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing FacilityGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLEL006AMedicare PIN