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NPI Code Detail

MEDICARE: MR. ROBINSON RUBEN CANCEL

MEDICARE:  MR. ROBINSON RUBEN CANCEL
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1487945010
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROBINSON RUBEN CANCEL
Provider Business Mailing Address
First Line : 2097 SW TRENTON LN
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34984-4322
Country : US
Telephone Number : 772-335-0713
Fax Number :
Provider Business Practice Location Address
First Line : 2097 SW TRENTON LN
Second Line :
City : PORT ST LUCIE
State : FL
Zip : 34984-4322
Country : US
Telephone Number : 772-335-0713
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2011
Last Update Date : 05/01/2011

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Directions to “ MR. ROBINSON RUBEN CANCEL ” Practice Location

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