MEDICARE: THEO ROBINSON II M.S.

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	247200000X	Other Technician
2	103K00000X	Behavior Analyst	1-16-23155	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740739408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THEO ROBINSON II M.S.

Provider Business Mailing Address
First Line	:	6000 S FRASER ST APT 12-107
Second Line	:
City	:	AURORA
State	:	CO
Zip	:	80016-4743
Country	:	US
Telephone Number	:	772-766-2538
Fax Number	:

Provider Business Practice Location Address
First Line	:	2170 S PARKER RD STE 100
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80231-5734
Country	:	US
Telephone Number	:	720-706-3396
Fax Number	:

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

Provider Enumeration Date	:	09/22/2016
Last Update Date	:	11/16/2023

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