Healthcare Provider Details

I. General information

NPI: 1235760182
Provider Name (Legal Business Name): RHAYE ANN M ROBINSON DT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 05/22/2024
Certification Date: 05/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N LAKE HOWARD DR
WINTER HAVEN FL
33881
US

IV. Provider business mailing address

PO BOX 2496
KOKOMO IN
46904-2496
US

V. Phone/Fax

Practice location:
  • Phone: 407-530-5063
  • Fax: 877-399-5578
Mailing address:
  • Phone: 765-457-8273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSZ11808
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: