Provider Demographics
NPI:1528104791
Name:BOOKER, ROBERT H (AP/DOM)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:BOOKER
Suffix:
Gender:M
Credentials:AP/DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5399 TOWER STREET
Mailing Address - Street 2:
Mailing Address - City:RIDGE MANOR
Mailing Address - State:FL
Mailing Address - Zip Code:33523
Mailing Address - Country:US
Mailing Address - Phone:352-458-9234
Mailing Address - Fax:
Practice Address - Street 1:14022 5TH ST STE B
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-4323
Practice Address - Country:US
Practice Address - Phone:352-458-9234
Practice Address - Fax:352-518-4627
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSCOPE OF PRACTICE174400000X, 175L00000X
FLAP738171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No174400000XOther Service ProvidersSpecialist
No175L00000XOther Service ProvidersHomeopath