Provider Demographics
NPI:1497966493
Name:JOHNSON, ROBIN LYNN (LMT)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7815 N DALE MABRY HWY
Mailing Address - Street 2:S102
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33614-3203
Mailing Address - Country:US
Mailing Address - Phone:813-932-3315
Mailing Address - Fax:813-935-9835
Practice Address - Street 1:7815 N DALE MABRY HWY
Practice Address - Street 2:S102
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33614-3203
Practice Address - Country:US
Practice Address - Phone:813-932-3315
Practice Address - Fax:813-935-9835
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA27434225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMA27434OtherMASSAGE THERAPY LICENSE