Basic Information
Provider Information
NPI: 1639158637
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: VINAY
FirstName: ROBIN
MiddleName: A
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7111 FAIRWAY DR
Address2: SUITE 400
City: PALM BEACH GARDENS
State: FL
PostalCode: 334184204
CountryCode: US
TelephoneNumber: 5617126265
FaxNumber: 5617127349
Practice Location
Address1: 8150 CHANCELLOR DR
Address2: SUITE 110
City: ORLANDO
State: FL
PostalCode: 328097691
CountryCode: US
TelephoneNumber: 4075874243
FaxNumber: 4072515053
Other Information
ProviderEnumerationDate: 01/10/2006
LastUpdateDate: 10/15/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XME93330FLY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZH0000XME93330FLN Allopathic & Osteopathic PhysiciansPathologyHematology

ID Information
IDTypeStateIssuerDescription
27415470005FL MEDICAID


Home