Provider Demographics
NPI:1164769006
Name:SCRIBNER, ROBERT DEAN
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:DEAN
Last Name:SCRIBNER
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 1:10500 SAN JOSE BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32257-6209
Mailing Address - Country:US
Mailing Address - Phone:904-288-6450
Mailing Address - Fax:904-288-6402
Practice Address - Street 1:10500 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32257-6209
Practice Address - Country:US
Practice Address - Phone:904-288-6450
Practice Address - Fax:904-288-6402
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2013-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS0026589183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist