Provider Demographics
NPI:1245355346
Name:ROBLETO, ARLETTE A URBINA (COTA)
Entity type:Individual
Prefix:MRS
First Name:ARLETTE
Middle Name:A URBINA
Last Name:ROBLETO
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:ARLETTE
Other - Middle Name:A ROBLETO
Other - Last Name:URBINA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:COTA
Mailing Address - Street 1:812 ROSTOCK CIR NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-9042
Mailing Address - Country:US
Mailing Address - Phone:321-676-7547
Mailing Address - Fax:
Practice Address - Street 1:812 ROSTOCK CIR NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-9042
Practice Address - Country:US
Practice Address - Phone:321-676-7547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA 518320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities