Healthcare Provider Details

I. General information

NPI: 1144825852
Provider Name (Legal Business Name): STORMY ROBBINS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STORM ROBBINS

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1762 SEA LARK LN
NAVARRE FL
32566-7406
US

IV. Provider business mailing address

PO BOX 259
SHALIMAR FL
32579-0259
US

V. Phone/Fax

Practice location:
  • Phone: 850-362-6824
  • Fax:
Mailing address:
  • Phone: 850-362-6826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: