Provider Demographics
NPI:1164410726
Name:LEADER-LANDAU, ROBIN (DO)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:LEADER-LANDAU
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 S PINE ISLAND RD STE 800
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33324-3923
Mailing Address - Country:US
Mailing Address - Phone:954-966-8000
Mailing Address - Fax:954-966-6614
Practice Address - Street 1:4500 SHERIDAN ST
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-3516
Practice Address - Country:US
Practice Address - Phone:954-966-8000
Practice Address - Fax:954-966-6614
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS8969208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL267297900Medicaid