Provider Demographics
NPI:1497213177
Name:BENJAMIN, ROBIN RAINA
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:RAINA
Last Name:BENJAMIN
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 1:170 OCEAN LANE DR APT 701
Mailing Address - Street 2:
Mailing Address - City:KEY BISCAYNE
Mailing Address - State:FL
Mailing Address - Zip Code:33149-1451
Mailing Address - Country:US
Mailing Address - Phone:305-586-6755
Mailing Address - Fax:
Practice Address - Street 1:240 CRANDON BLVD STE 288
Practice Address - Street 2:
Practice Address - City:KEY BISCAYNE
Practice Address - State:FL
Practice Address - Zip Code:33149-1621
Practice Address - Country:US
Practice Address - Phone:305-586-6755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1041C0700X
FL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical