Healthcare Provider Details

I. General information

NPI: 1164926176
Provider Name (Legal Business Name): INNA ROBRAHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 W UNDERWOOD ST MP 153
ORLANDO FL
32806
US

IV. Provider business mailing address

52 W UNDERWOOD ST MP 153
ORLANDO FL
32806
US

V. Phone/Fax

Practice location:
  • Phone: 321-841-2558
  • Fax: 407-849-6470
Mailing address:
  • Phone: 321-841-3900
  • Fax: 321-843-6075

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME148453
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number208811
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberTRN26078
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: