Provider Demographics
NPI:1528947256
Name:ROBINSON, LEO ALLEN
Entity type:Individual
Prefix:MR
First Name:LEO
Middle Name:ALLEN
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:LOUISIANA
Other - Middle Name:
Other - Last Name:PURPOSE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2904 XAVIER CT
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-3426
Mailing Address - Country:US
Mailing Address - Phone:347-287-2244
Mailing Address - Fax:
Practice Address - Street 1:2904 XAVIER CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32826-3426
Practice Address - Country:US
Practice Address - Phone:347-287-2244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL01002066P175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist