Provider Demographics
NPI:1669412417
Name:JULIO ROBLA MD PA
Entity type:Organization
Organization Name:JULIO ROBLA MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:JULIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:305-275-6770
Mailing Address - Street 1:PO BOX 160022
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33116-0022
Mailing Address - Country:US
Mailing Address - Phone:305-275-6770
Mailing Address - Fax:305-275-6440
Practice Address - Street 1:7600 SW 87TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3601
Practice Address - Country:US
Practice Address - Phone:305-275-6770
Practice Address - Fax:305-275-6440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-08
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME61390332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
1015925OtherNCPDP PROVIDER IDENTIFICATION NUMBER
1015925OtherNCPDP PROVIDER IDENTIFICATION NUMBER