Healthcare Provider Details

I. General information

NPI: 1518680008
Provider Name (Legal Business Name): KATIA ROBELO APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2022
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 SEA HARBOR DR W
ORMOND BEACH FL
32176-2129
US

IV. Provider business mailing address

5 SEA HARBOR DR W
ORMOND BEACH FL
32176-2129
US

V. Phone/Fax

Practice location:
  • Phone: 954-604-0878
  • Fax: 386-204-7228
Mailing address:
  • Phone: 954-604-0878
  • Fax: 386-204-7228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11021930
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: