Provider Demographics
NPI:1902913056
Name:COOPER, ROBIN LEE (RPH)
Entity type:Individual
Prefix:MR
First Name:ROBIN
Middle Name:LEE
Last Name:COOPER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4311 N RIVER VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-6535
Mailing Address - Country:US
Mailing Address - Phone:813-493-8269
Mailing Address - Fax:
Practice Address - Street 1:4311 N RIVER VIEW AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33607-6535
Practice Address - Country:US
Practice Address - Phone:813-493-8269
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2020-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS14718183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist