Provider Demographics
NPI:1992749758
Name:HAHNER, ROBIN J (PA-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:J
Last Name:HAHNER
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 1:3370 BURNS RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33410-4327
Mailing Address - Country:US
Mailing Address - Phone:561-775-1061
Mailing Address - Fax:561-775-1064
Practice Address - Street 1:3370 BURNS RD
Practice Address - Street 2:SUITE 205
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33410-4327
Practice Address - Country:US
Practice Address - Phone:561-775-1061
Practice Address - Fax:561-775-1064
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA 3230363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP32803Medicare UPIN
FLE5062ZMedicare ID - Type Unspecified