Provider Demographics
NPI:1366508723
Name:ROBINSON, SCOTT BRADY (LMT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:BRADY
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1307 GULF STREAM CIR APT 304
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-2821
Mailing Address - Country:US
Mailing Address - Phone:813-368-1193
Mailing Address - Fax:
Practice Address - Street 1:330 PAULS DR STE 102
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4801
Practice Address - Country:US
Practice Address - Phone:813-643-1242
Practice Address - Fax:813-643-1246
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA 43666225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist