Healthcare Provider Details

I. General information

NPI: 1306377981
Provider Name (Legal Business Name): MS. FLORITA IRMA EUDIA ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/24/2017
Last Update Date: 03/24/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 S PRIMROSE DR
ORLANDO FL
32806-2501
US

IV. Provider business mailing address

10634 BOLAND DR
ORLANDO FL
32825-5632
US

V. Phone/Fax

Practice location:
  • Phone: 321-230-2414
  • Fax:
Mailing address:
  • Phone: 321-230-2414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH16466
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: