Provider Demographics
NPI:1124404561
Name:MILLER, ROBYN LEE (PT, DPT)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:LEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 COMMED BLVD
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32763-8321
Mailing Address - Country:US
Mailing Address - Phone:386-775-7488
Mailing Address - Fax:
Practice Address - Street 1:801 WOODBURY RD STE 103
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32828-4514
Practice Address - Country:US
Practice Address - Phone:407-373-6082
Practice Address - Fax:407-373-6083
Is Sole Proprietor?:No
Enumeration Date:2015-08-08
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30342225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist