Provider Demographics
NPI:1679014690
Name:PAULINA ROBALINO LCSW, LLC
Entity Type:Organization
Organization Name:PAULINA ROBALINO LCSW, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAULINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBALINO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:813-404-7216
Mailing Address - Street 1:13919 CARROLLWOOD VILLAGE RUN
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-2746
Mailing Address - Country:US
Mailing Address - Phone:813-404-7216
Mailing Address - Fax:
Practice Address - Street 1:13919 CARROLLWOOD VILLAGE RUN
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2746
Practice Address - Country:US
Practice Address - Phone:813-404-7216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW88481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL015818700Medicaid