Provider Demographics
NPI:1306383740
Name:ROBINSON, LAUREL N
Entity Type:Individual
Prefix:MS
First Name:LAUREL
Middle Name:N
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4216 LITTLE RD
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34655-1605
Mailing Address - Country:US
Mailing Address - Phone:727-844-7555
Mailing Address - Fax:727-376-8841
Practice Address - Street 1:4216 LITTLE RD
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-1605
Practice Address - Country:US
Practice Address - Phone:727-844-7555
Practice Address - Fax:727-376-8841
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAS 2325237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL610054600Medicaid
FLJ006GOtherBCBS