Healthcare Provider Details

I. General information

NPI: 1346829348
Provider Name (Legal Business Name): ROBENSS PLANCHER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2021
Last Update Date: 10/23/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6910 OLD WOLF BAY RD
PALATKA FL
32177-6800
US

IV. Provider business mailing address

900 S PINE ISLAND RD STE 800
PLANTATION FL
33324-3923
US

V. Phone/Fax

Practice location:
  • Phone: 386-328-7337
  • Fax: 386-325-3742
Mailing address:
  • Phone: 954-967-6400
  • Fax: 954-337-5755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAPRN11011811
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: