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Organization
MIND REVIVE PSYCHIATRY LLC
Active
Organization
MIND REVIVE PSYCHIATRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARCUS L ROBINSON PMHNP-BC (PSYCHIATRIC NURSE PRACTITIONER)
(863) 399-2664
Entity
Organization
Contact information
Practice address
1863 SKYVIEW DR, AUBURNDALE, FL 33823-5445
(407) 561-2500
Mailing address
PO BOX 640, AUBURNDALE, FL 33823-0640
(407) 561-2500
(833) 410-2620
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/07/2020
Last updated
08/22/2023
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