Provider Demographics
NPI:1245889476
Name:DIMOND, ROBIN BELLE
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:BELLE
Last Name:DIMOND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:BELLE
Other - Last Name:TEPLITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10108 DOUGLAS OAKS CIR APT 202
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33610-8607
Mailing Address - Country:US
Mailing Address - Phone:813-708-2164
Mailing Address - Fax:
Practice Address - Street 1:1001 E BAKER ST STE 100
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-3700
Practice Address - Country:US
Practice Address - Phone:813-754-5555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator