MEDICARE: VICTORIA NASHAE ROBINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376J00000X	Homemaker	237946	FL
2	372600000X	Adult Companion	237946	FL

General Provider Information

NPI Number	:	1376213090
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA NASHAE ROBINSON

Provider Business Mailing Address
First Line	:	PO BOX 503
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33902-0503
Country	:	US
Telephone Number	:	239-634-6025
Fax Number	:

Provider Business Practice Location Address
First Line	:	1620 MEDICAL LN STE 213
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33907-1150
Country	:	US
Telephone Number	:	239-634-6025
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/14/2021
Last Update Date	:	09/17/2021

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