Provider Demographics
NPI:1801113402
Name:ROBINSON, ANGELA DIANNE
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:DIANNE
Last Name:ROBINSON
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 1:668 N ORLANDO AVE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4473
Mailing Address - Country:US
Mailing Address - Phone:407-599-1963
Mailing Address - Fax:407-599-1959
Practice Address - Street 1:668 N ORLANDO AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4473
Practice Address - Country:US
Practice Address - Phone:407-599-1963
Practice Address - Fax:407-599-1959
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-23
Last Update Date:2010-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCE9973970332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies