Provider Demographics
NPI:1598549446
Name:MCDERMOTT, ROBIN FATOVIC (PSYD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:FATOVIC
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:FATOVIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:27499 RIVERVIEW CENTER BLVD STE 227
Mailing Address - Street 2:
Mailing Address - City:BONITA SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34134-4335
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27499 RIVERVIEW CENTER BLVD STE 227
Practice Address - Street 2:
Practice Address - City:BONITA SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34134-4335
Practice Address - Country:US
Practice Address - Phone:239-289-9796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY12785103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical