Active NPI
Matthew Jesus Robles
- Other Technician
- Bartow, FL
National Provider Identifier
1851076665
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- License
- RPT107444
- Practice address
- 395 E Van Fleet Dr
Bartow, FL 33830-3833 - Phone
- (863) 533-6669
- NPI assigned
- Jun 19, 2023
- Last updated
- Jun 19, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | RPT107444 | FL | Primary |
Addresses
Primary practice location
395 E Van Fleet Dr
Bartow, FL 33830-3833
Mailing address
395 E Van Fleet Dr
Bartow, FL 33830-3833
Phone (863) 533-6669
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPT107444 | FL | MD | Other Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
395 E Van Fleet Dr
Bartow, FL 33830
Phone (863) 533-6669
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687132800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687132800000",
"number": "1851076665",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "395 E VAN FLEET DR",
"city": "BARTOW",
"state": "FL",
"postal_code": "338303833",
"telephone_number": "863-533-6669",
"fax_number": "863-533-1963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "395 E VAN FLEET DR",
"city": "BARTOW",
"state": "FL",
"postal_code": "338303833",
"telephone_number": "863-533-6669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBLES",
"first_name": "MATTHEW",
"middle_name": "JESUS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-06-19",
"last_updated": "2023-06-19",
"certification_date": "2023-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": "FL",
"license": "RPT107444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bartow, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.