1316034614 NPI number — ROBERT STEPHEN ADCOCK MSSW

Table of content: NICOLE ARTAMENKO FNP-C (NPI 1083312409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316034614 NPI number — ROBERT STEPHEN ADCOCK MSSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ADCOCK
Provider First Name:
ROBERT
Provider Middle Name:
STEPHEN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ADCOCK
Provider Other First Name:
ROBBY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1316034614
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 320331
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAMPA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33679-2331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
813-335-5444
Provider Business Mailing Address Fax Number:
727-576-0651

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 S HOOVER BLVD
Provider Second Line Business Practice Location Address:
SUITE 170
Provider Business Practice Location Address City Name:
TAMPA
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33609-3540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
813-335-5444
Provider Business Practice Location Address Fax Number:
727-576-0651
Provider Enumeration Date:
10/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW 5409 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: FL1429 . This is a "BRADMAN NETWORK" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 198686 . This is a "COMPSYCH" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2074595 . This is a "CIGNA BEHAVIORAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 7532382 . This is a "AETNA BEHAVIORAL" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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