Healthcare Provider Details

I. General information

NPI: 1588058648
Provider Name (Legal Business Name): ROBIN BURGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 10/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 NW 17TH AVE STE 130
DELRAY BEACH FL
33445-2588
US

IV. Provider business mailing address

111 E 210TH ST
BRONX NY
10467-2401
US

V. Phone/Fax

Practice location:
  • Phone: 561-819-0857
  • Fax: 561-549-0173
Mailing address:
  • Phone: 718-920-4321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License NumberME140986
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: