Basic Information
| Provider Information | |||||||||
| NPI: | 1053712786 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | O'ROURKE | ||||||||
| FirstName: | ROBIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 14690 SPRING HILL DR | ||||||||
| Address2: | 101 | ||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346098102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3527990046 | ||||||||
| FaxNumber: | 3527990115 | ||||||||
| Practice Location | |||||||||
| Address1: | 5382 SPRING HILL DR | ||||||||
| Address2: | |||||||||
| City: | SPRING HILL | ||||||||
| State: | FL | ||||||||
| PostalCode: | 346064562 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3522002190 | ||||||||
| FaxNumber: | 3522002191 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2014 | ||||||||
| LastUpdateDate: | 11/07/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | ND6360 | FL | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.