Provider Demographics
NPI:1548612773
Name:WESSELS, ROBIN KIMBROUGH (AUD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:KIMBROUGH
Last Name:WESSELS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:ANNA
Other - Last Name:KIMBROUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2845 87TH PL N
Mailing Address - Street 2:APT 302
Mailing Address - City:PINELLAS PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33782-6227
Mailing Address - Country:US
Mailing Address - Phone:727-767-6347
Mailing Address - Fax:
Practice Address - Street 1:5881 RAND BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5115
Practice Address - Country:US
Practice Address - Phone:727-767-6347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-12
Last Update Date:2016-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAZ708231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist