Healthcare Provider Details
I. General information
NPI: 1063942001
Provider Name (Legal Business Name): ROBBINS - PIERRE-VAL & ASSOCIATES LIMITED LIABILITY COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/13/2017
Last Update Date: 06/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11705 BOYETTE RD STE 169
RIVERVIEW FL
33569-5533
US
IV. Provider business mailing address
11705 BOYETTE RD STE 169
RIVERVIEW FL
33569-5533
US
V. Phone/Fax
- Phone: 813-297-6326
- Fax:
- Phone: 813-297-6326
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DEVENIE
J
ROBBINS
Title or Position: CO-OWNER
Credential: ARNP
Phone: 813-297-6326