Provider Demographics
NPI:1184847824
Name:VARNER, ROBYN LESLIE (PT)
Entity Type:Individual
Prefix:MISS
First Name:ROBYN
Middle Name:LESLIE
Last Name:VARNER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3267 PINS LN
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32563-3204
Mailing Address - Country:US
Mailing Address - Phone:850-932-8347
Mailing Address - Fax:850-455-0938
Practice Address - Street 1:12385 SORRENTO RD
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32507-8664
Practice Address - Country:US
Practice Address - Phone:850-453-8549
Practice Address - Fax:850-455-0938
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL0011152174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL0011152OtherSTATE LISCENSURE