Healthcare Provider Details

I. General information

NPI: 1982450318
Provider Name (Legal Business Name): ROBERT CHARLES LOHLEIN II
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9124 SW 70TH TER
MIAMI FL
33173-2462
US

IV. Provider business mailing address

9124 SW 70TH TER
MIAMI FL
33173-2462
US

V. Phone/Fax

Practice location:
  • Phone: 786-942-9690
  • Fax:
Mailing address:
  • Phone: 786-942-9690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number9481771
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number9481771
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number9481771
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11030438
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number11030438
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: