Healthcare Provider Details

I. General information

NPI: 1245433200
Provider Name (Legal Business Name): ROBIN GOODKIN SEMPLE F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 NW 1ST ST STE 110
MIAMI FL
33128-1902
US

IV. Provider business mailing address

517 DE SOTO DR
MIAMI SPRINGS FL
33166-6010
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-7200
  • Fax: 306-372-1098
Mailing address:
  • Phone: 305-884-8477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1366912
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: