Provider Demographics
NPI:1497207757
Name:ROBINSON, TONYA
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
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 1:111 NW 183RD ST STE 424
Mailing Address - Street 2:
Mailing Address - City:MIAMI GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33169-4619
Mailing Address - Country:US
Mailing Address - Phone:786-657-3276
Mailing Address - Fax:786-565-9193
Practice Address - Street 1:111 NW 183RD ST STE 424
Practice Address - Street 2:
Practice Address - City:MIAMI GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33169-4619
Practice Address - Country:US
Practice Address - Phone:786-657-3276
Practice Address - Fax:786-565-9193
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL010882700Medicaid