Provider Demographics
NPI:1417578444
Name:ROBINSON, MARSHA (DMD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 MANHATTAN AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10026-2098
Mailing Address - Country:US
Mailing Address - Phone:407-733-5853
Mailing Address - Fax:
Practice Address - Street 1:3135 COLUMBIA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:TITUSVILLE
Practice Address - State:FL
Practice Address - Zip Code:32780-7833
Practice Address - Country:US
Practice Address - Phone:321-567-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
FLDN25891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program