Individual provider Active NPI

Robin Nicole Blackman

  • General Practice Dentistry
  • Pembroke Pines, FL
National Provider Identifier
1427510312
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24314 Issued in FL
Practice address
1601 N Palm Ave Ste 104
Pembroke Pines, FL 33026-3240
Phone
(954) 998-4943
NPI assigned
Apr 1, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 24314 FL
General Practice Dentistry 1223G0001X 24314 FL Primary

Addresses

Primary practice location

1601 N Palm Ave Ste 104
Pembroke Pines, FL 33026-3240

Mailing address

208 Hospital Dr NE
Fort Walton Beach, FL 32548-5068
Phone (850) 243-8124

Other practice location 1

208 Hospital Dr NE
Fort Walton Beach, FL 32548-5068
Phone (850) 243-8124

Other practice location 2

3801 Hollywood Blvd Ste 225
Hollywood, FL 33021-6849
Phone (954) 573-1930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
24314FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bartlett Family and Cosmetic Dentistry, PLLC General Practice CurrentSince Jun 26, 2022 Accepting new patients

Locations

208 Hospital Dr NE
Ft Walton Bch, FL 32548
Phone (850) 243-8124

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1427510312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 HOSPITAL DR NE",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325485068",
            "telephone_number": "850-243-8124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 N PALM AVE STE 104",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330263240",
            "telephone_number": "954-998-4943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Hospital Dr NE",
            "address_purpose": "LOCATION",
            "city": "Fort Walton Beach",
            "state": "FL",
            "postal_code": "325485068",
            "country_code": "US",
            "telephone_number": "850-243-8124",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3801 Hollywood Blvd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Hollywood",
            "state": "FL",
            "postal_code": "330216849",
            "country_code": "US",
            "telephone_number": "954-573-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACKMAN",
        "first_name": "ROBIN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-01",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "24314",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "24314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.