Healthcare Provider Details

I. General information

NPI: 1720698947
Provider Name (Legal Business Name): ROBINSON REMONVILLE APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: ROBINSON REMONVILLE APRN

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6045 SW 40TH ST
MIRAMAR FL
33023-5107
US

IV. Provider business mailing address

6045 SW 40TH ST
MIRAMAR FL
33023-5107
US

V. Phone/Fax

Practice location:
  • Phone: 305-896-8711
  • Fax:
Mailing address:
  • Phone: 305-896-8711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11008300
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN11008310
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: