Provider Demographics
NPI:1548617533
Name:ROBINSON, JOHN HENRY JR
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:HENRY
Last Name:ROBINSON
Suffix:JR
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 1:2600 HARDEN BLVD LOT 3
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33803-7928
Mailing Address - Country:US
Mailing Address - Phone:863-904-5009
Mailing Address - Fax:
Practice Address - Street 1:2600 HARDEN BLVD LOT 3
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33803-7928
Practice Address - Country:US
Practice Address - Phone:863-904-5009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care