Active NPI
Robin Nicole Blackman
- General Practice Dentistry
- Pembroke Pines, FL
National Provider Identifier
1427510312
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 24314
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 24314 | FL | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bartlett Family and Cosmetic Dentistry, PLLC | General Practice | Current | 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.
-
- General Practice Dentistry
- Fort Walton Beach, FL
- NPI 1437881950
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.