MEDICARE: DONNA CAROL ROBINSON-BROWNLEE RD, LD

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	133V00000X	Registered Dietitian	ND394	FL

General Provider Information

NPI Number	:	1861995490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DONNA CAROL ROBINSON-BROWNLEE RD, LD

Provider Business Mailing Address
First Line	:	9013 LAKE CHARITY DR
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-4213
Country	:	US
Telephone Number	:	321-436-9108
Fax Number	:

Provider Business Practice Location Address
First Line	:	9013 LAKE CHARITY DR
Second Line	:
City	:	MAITLAND
State	:	FL
Zip	:	32751-4213
Country	:	US
Telephone Number	:	321-436-9108
Fax Number	:

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

Provider Enumeration Date	:	03/09/2018
Last Update Date	:	07/21/2022

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