Provider Demographics
NPI:1811226301
Name:ROBLES, IDALIA (RN)
Entity Type:Individual
Prefix:
First Name:IDALIA
Middle Name:
Last Name:ROBLES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ST 187 MEDIANIA BAJA
Mailing Address - Street 2:SECTOR LA LECHONERA
Mailing Address - City:LOIZA
Mailing Address - State:PR
Mailing Address - Zip Code:00772
Mailing Address - Country:US
Mailing Address - Phone:787-550-5419
Mailing Address - Fax:
Practice Address - Street 1:MEDIANIA BAJA AVE.187
Practice Address - Street 2:SECTOR LA LECHONERA
Practice Address - City:LOIZA
Practice Address - State:PR
Practice Address - Zip Code:00772
Practice Address - Country:US
Practice Address - Phone:787-550-5419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-14
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR24116163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse