Provider Demographics
NPI:1255827044
Name:ROBERSON, HICHINACA (ARNP)
Entity Type:Individual
Prefix:
First Name:HICHINACA
Middle Name:
Last Name:ROBERSON
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 1:719 RODEL CV
Mailing Address - Street 2:
Mailing Address - City:LAKE MARY
Mailing Address - State:FL
Mailing Address - Zip Code:32746-5716
Mailing Address - Country:US
Mailing Address - Phone:407-302-3119
Mailing Address - Fax:407-302-7038
Practice Address - Street 1:719 RODEL CV STE 1015
Practice Address - Street 2:
Practice Address - City:LAKE MARY
Practice Address - State:FL
Practice Address - Zip Code:32746-5716
Practice Address - Country:US
Practice Address - Phone:321-843-1391
Practice Address - Fax:407-636-7864
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2023-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9297122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily