Healthcare Provider Details

I. General information

NPI: 1740529650
Provider Name (Legal Business Name): MALERIE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2013
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1191 COMMERCE PARK DR
ALTAMONTE SPRINGS FL
32714-2035
US

IV. Provider business mailing address

1191 COMMERCE PARK DR
ALTAMONTE SPRINGS FL
32714-2035
US

V. Phone/Fax

Practice location:
  • Phone: 407-951-8936
  • Fax:
Mailing address:
  • Phone: 407-951-8936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Y00000X
TaxonomyClinical Exercise Physiologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225500000X
TaxonomyRespiratory/Developmental/Rehabilitative Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code226300000X
TaxonomyKinesiotherapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: