Provider Demographics
NPI:1679227862
Name:ROBINSON, AQUEBA
Entity Type:Individual
Prefix:
First Name:AQUEBA
Middle Name:
Last Name:ROBINSON
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 1:3939 DUNN RD
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28312-8533
Mailing Address - Country:US
Mailing Address - Phone:910-920-4149
Mailing Address - Fax:
Practice Address - Street 1:3939 DUNN RD
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:NC
Practice Address - Zip Code:28312-8533
Practice Address - Country:US
Practice Address - Phone:910-920-4149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-08
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician