Provider Demographics
NPI:1619335007
Name:ROBLES, ISABELLA
Entity Type:Individual
Prefix:
First Name:ISABELLA
Middle Name:
Last Name:ROBLES
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 1:16336 COOPERS HAWK AVE
Mailing Address - Street 2:
Mailing Address - City:CLERMONT
Mailing Address - State:FL
Mailing Address - Zip Code:34714-6150
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7550 FUTURES DR
Practice Address - Street 2:108
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-9095
Practice Address - Country:US
Practice Address - Phone:844-743-6224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization