Provider Demographics
NPI:1265935183
Name:PINA, ROBERT J
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:J
Last Name:PINA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 LINTON BLVD.
Mailing Address - Street 2:BLDG. A-201
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445
Mailing Address - Country:US
Mailing Address - Phone:561-496-6622
Mailing Address - Fax:561-496-6577
Practice Address - Street 1:4800 LINTON BLVD.
Practice Address - Street 2:BLDG. A-201
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33445
Practice Address - Country:US
Practice Address - Phone:561-496-6622
Practice Address - Fax:561-496-6577
Is Sole Proprietor?:No
Enumeration Date:2018-03-16
Last Update Date:2018-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT4094225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist