Healthcare Provider Details

I. General information

NPI: 1487644258
Provider Name (Legal Business Name): KEVIN T ROBINSON MS, ATC, LAT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6037 WINDHOVER DR
ORLANDO FL
32819-7529
US

IV. Provider business mailing address

6037 WINDHOVER DR
ORLANDO FL
32819-7529
US

V. Phone/Fax

Practice location:
  • Phone: 386-264-5168
  • Fax:
Mailing address:
  • Phone: 386-264-5168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAL419
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: