MEDICARE: KRISTAN M ROBINSON PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	PTA 21375	FL

General Provider Information

NPI Number	:	1821242124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTAN M ROBINSON PTA

Provider Business Mailing Address
First Line	:	13137 SORRENTO RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32507-8777
Country	:	US
Telephone Number	:	850-497-1518
Fax Number	:	850-497-9830

Provider Business Practice Location Address
First Line	:	13137 SORRENTO RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32507-8777
Country	:	US
Telephone Number	:	850-497-1518
Fax Number	:	850-497-9830

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2008
Last Update Date	:	11/13/2008

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