Provider Demographics
NPI:1508037383
Name:ROBIDOUX, STEVEN KENNETH (RN)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:KENNETH
Last Name:ROBIDOUX
Suffix:
Gender:M
Credentials:RN
Other - Prefix:MR
Other - First Name:STEVEN
Other - Middle Name:KENNETH
Other - Last Name:ROBIDOUX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:3176 TROUT CREEK CT
Mailing Address - Street 2:
Mailing Address - City:ST AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-2436
Mailing Address - Country:US
Mailing Address - Phone:904-940-9320
Mailing Address - Fax:
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-3003
Practice Address - Country:US
Practice Address - Phone:352-265-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-19
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 9253776163W00000X
GARN177617163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse