Provider Demographics
NPI:1992120109
Name:ZULUETA, ROBINSON
Entity type:Individual
Prefix:
First Name:ROBINSON
Middle Name:
Last Name:ZULUETA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6731 HIGH KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-1864
Mailing Address - Country:US
Mailing Address - Phone:863-521-4387
Mailing Address - Fax:
Practice Address - Street 1:6731 HIGH KNOLL DR
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-1864
Practice Address - Country:US
Practice Address - Phone:863-521-4387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT6415225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist