Healthcare Provider Details

I. General information

NPI: 1053666545
Provider Name (Legal Business Name): ROBIN RIDDICK PINERO BA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2012
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 OUTER ROAD SUITE B
ORLANDO FL
32814-6601
US

IV. Provider business mailing address

315 N LAKEMONT AVE SUITE B
WINTER PARK FL
32792-3205
US

V. Phone/Fax

Practice location:
  • Phone: 407-217-1401
  • Fax:
Mailing address:
  • Phone: 407-830-6412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number0-01-0301
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: