Provider Demographics
NPI:1992858898
Name:ROBERTS, CINDY HOUSE (RN)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:HOUSE
Last Name:ROBERTS
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 1:7819 COUNTRY CLUB RD N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-3750
Mailing Address - Country:US
Mailing Address - Phone:727-709-4014
Mailing Address - Fax:727-343-4402
Practice Address - Street 1:500 7TH AVE S
Practice Address - Street 2:DEPT 7470
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4820
Practice Address - Country:US
Practice Address - Phone:727-767-4403
Practice Address - Fax:727-767-4715
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
FLRN2943592163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Not Answered163WP0200XNursing Service ProvidersRegistered NursePediatrics