Provider Demographics
NPI:1992025944
Name:ROBALINO, VANESSA INES (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:INES
Last Name:ROBALINO
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10894 SW 235TH ST
Mailing Address - Street 2:
Mailing Address - City:HOMESTEAD
Mailing Address - State:FL
Mailing Address - Zip Code:33032-6323
Mailing Address - Country:US
Mailing Address - Phone:954-297-0269
Mailing Address - Fax:
Practice Address - Street 1:4908 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-2439
Practice Address - Country:US
Practice Address - Phone:305-207-5870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-01
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9105245363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical