Provider Demographics
NPI:1205021797
Name:ROBATEAU, DIANE L (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:L
Last Name:ROBATEAU
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MRS
Other - First Name:DIANE
Other - Middle Name:L
Other - Last Name:ROBATEAU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 370333
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-0333
Mailing Address - Country:US
Mailing Address - Phone:305-502-6544
Mailing Address - Fax:305-397-1650
Practice Address - Street 1:6763 BAYFRONT DR
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-7090
Practice Address - Country:US
Practice Address - Phone:706-341-7062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-08
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9261687363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily