Provider Demographics
NPI:1003855891
Name:GLINKA, ROBIN S (MPT, ATC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:S
Last Name:GLINKA
Suffix:
Gender:F
Credentials:MPT, ATC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:S
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT, ATC
Mailing Address - Street 1:35008 EMERALD COAST PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:DESTIN
Mailing Address - State:FL
Mailing Address - Zip Code:32541-4753
Mailing Address - Country:US
Mailing Address - Phone:850-687-9416
Mailing Address - Fax:
Practice Address - Street 1:35008 EMERALD COAST PKWY STE 400
Practice Address - Street 2:
Practice Address - City:DESTIN
Practice Address - State:FL
Practice Address - Zip Code:32541-4753
Practice Address - Country:US
Practice Address - Phone:850-714-6166
Practice Address - Fax:850-714-6167
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 16800225100000X
FLPT22209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL891320000Medicaid
FLAC932ZOtherMEDICARE PTAN