Healthcare Provider Details

I. General information

NPI: 1952237307
Provider Name (Legal Business Name): MADELYN MARIE ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4595 NORTHLAKE BLVD
PALM BEACH GARDENS FL
33418-4647
US

IV. Provider business mailing address

5711 SW 86TH ST
SOUTH MIAMI FL
33143-8206
US

V. Phone/Fax

Practice location:
  • Phone: 561-427-7711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN32034
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: