MEDICARE: LYNNE SUSAN ROBERTS ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	2168512	FL

General Provider Information

NPI Number	:	1134188899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE SUSAN ROBERTS ARNP

Provider Business Mailing Address
First Line	:	1955 N HIBISCUS DR
Second Line	:
City	:	NORTH MIAMI
State	:	FL
Zip	:	33181-2353
Country	:	US
Telephone Number	:	305-355-8034
Fax Number	:

Provider Business Practice Location Address
First Line	:	1695 NW 9TH AVE
Second Line	:
City	:	MIAMI
State	:	FL
Zip	:	33136-1409
Country	:	US
Telephone Number	:	305-355-8034
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/21/2006
Last Update Date	:	07/08/2007

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