Healthcare Provider Details

I. General information

NPI: 1366569022
Provider Name (Legal Business Name): GEORGETTE M ROBINSON PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 SW 137TH AVE SUITE 116
MIAMI FL
33186-1411
US

IV. Provider business mailing address

14501 SW 111TH TER
MIAMI FL
33186-6697
US

V. Phone/Fax

Practice location:
  • Phone: 305-382-9991
  • Fax: 305-382-9550
Mailing address:
  • Phone: 305-386-6452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number20799
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: