Individual
ROBINSON J OMOTOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
400 N PLEASANT AVE, CENTRALIA, IL 62801-3056
(618) 436-5461
Mailing address
PO BOX 917756, ORLANDO, FL 32891-7756
(352) 867-8898
(352) 732-6282
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
ARNP2030632
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G2971
BLUE CROSS BLUE SHIELD
FL
Enumeration date
08/31/2006
Last updated
07/08/2007
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