=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306461124
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EDWARD CHARLES ROBINSON RPH
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/09/2020
-----------------------------------------------------
Last Update Date | 11/27/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1619 DEL PRADO BLVD S
-----------------------------------------------------
City | CAPE CORAL
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33990-3713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 239-772-4900
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13421 SEASIDE HARBOUR DR
-----------------------------------------------------
City | NORTH FORT MYERS
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33903-7122
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 813-545-5574
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PS21066
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------