Provider Demographics
NPI:1306377981
Name:ROBINSON, FLORITA IRMA EUDIA
Entity Type:Individual
Prefix:MS
First Name:FLORITA
Middle Name:IRMA EUDIA
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10634 BOLAND DR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5632
Mailing Address - Country:US
Mailing Address - Phone:321-230-2414
Mailing Address - Fax:
Practice Address - Street 1:1465 S PRIMROSE DR
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32806-2501
Practice Address - Country:US
Practice Address - Phone:321-230-2414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH16466124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR152249578350Medicaid
FLR152249578350Medicaid