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NPI Code Detail

MEDICARE: MR. SHELDON J ROBERTS PA

MEDICARE: MR. SHELDON J ROBERTS PA
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
1363A00000XPhysician AssistantPA9104118FL
2363A00000XPhysician Assistant1863AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1225024680
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SHELDON J ROBERTS PA
Provider Business Mailing Address
First Line : 509 E 23RD ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-5307
Country : US
Telephone Number : 850-215-8999
Fax Number : 850-215-8681
Provider Business Practice Location Address
First Line : 509 E 23RD ST
Second Line :
City : PANAMA CITY
State : FL
Zip : 32405-5307
Country : US
Telephone Number : 850-215-8999
Fax Number : 850-215-8681
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2005
Last Update Date : 06/07/2012

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Directions to “ MR. SHELDON J ROBERTS PA” Practice Location

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