Healthcare Provider Details

I. General information

NPI: 1033365143
Provider Name (Legal Business Name): ROBYN PANTHER GLEASON ARNP, FNP(BC)
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2008
Last Update Date: 12/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 HILLDALE AVE
ORMOND BEACH FL
32176-5724
US

IV. Provider business mailing address

136 HILLDALE AVE
ORMOND BEACH FL
32176-5724
US

V. Phone/Fax

Practice location:
  • Phone: 386-682-3564
  • Fax: 386-677-7476
Mailing address:
  • Phone: 386-682-3564
  • Fax: 386-677-7476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3244842
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: