Provider Demographics
NPI:1962541433
Name:POLINER-JOHNSON, ROBYN ANN (PA-C)
Entity type:Individual
Prefix:MS
First Name:ROBYN
Middle Name:ANN
Last Name:POLINER-JOHNSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 S K ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33460-4130
Mailing Address - Country:US
Mailing Address - Phone:714-393-4409
Mailing Address - Fax:
Practice Address - Street 1:2015 OCEAN DR
Practice Address - Street 2:SUITE 11
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-5131
Practice Address - Country:US
Practice Address - Phone:561-364-8056
Practice Address - Fax:561-364-8507
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9103590363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant