Provider Demographics
NPI:1164762886
Name:ROEBUCK, ROBIN (PHARMD, RPH)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:ROEBUCK
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 HARTFORD CT
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-7522
Mailing Address - Country:US
Mailing Address - Phone:561-712-9654
Mailing Address - Fax:
Practice Address - Street 1:1935 HARTFORD CT
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-7522
Practice Address - Country:US
Practice Address - Phone:561-712-9654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS41310183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist