Provider Demographics
NPI:1679699912
Name:GOLDSTEIN, ROBIN LINDA (EDD)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LINDA
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 GLADES RD
Mailing Address - Street 2:SUITE100
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4194
Mailing Address - Country:US
Mailing Address - Phone:561-245-4640
Mailing Address - Fax:561-892-7778
Practice Address - Street 1:7777 GLADES RD
Practice Address - Street 2:SUITE100
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4194
Practice Address - Country:US
Practice Address - Phone:561-245-4640
Practice Address - Fax:561-892-7778
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003699103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL59327OtherBCBS PROVIDER NUMBER
FL59327OtherBCBS PROVIDER NUMBER