Provider Demographics
NPI:1215246475
Name:ROBINSON, TERRENCE DOMAIN GARFIELD (MD)
Entity type:Individual
Prefix:DR
First Name:TERRENCE
Middle Name:DOMAIN GARFIELD
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DOMAIN
Other - Middle Name:TERRENCE GARFIELD
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1608 SE 3RD AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33316-2564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:100 NW 82ND AVE
Practice Address - Street 2:SUITE 201-202
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-7809
Practice Address - Country:US
Practice Address - Phone:954-320-2877
Practice Address - Fax:954-370-0697
Is Sole Proprietor?:No
Enumeration Date:2010-10-05
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 107869207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL002888300Medicaid
FL002888300Medicaid