MEDICARE: KARLA P ROBERTS LMHC

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	101Y00000X	Counselor	MH9998	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MH9998	OTHER	FL	LICENSE

General Provider Information

NPI Number	:	1235438771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARLA P ROBERTS LMHC

Provider Business Mailing Address
First Line	:	10179 SW 98TH TER
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32608-6024
Country	:	US
Telephone Number	:	352-215-7025
Fax Number	:

Provider Business Practice Location Address
First Line	:	2602 NW 6TH ST
Second Line	:
City	:	GAINESVILLE
State	:	FL
Zip	:	32609-2944
Country	:	US
Telephone Number	:	352-215-7025
Fax Number	:

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

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	03/23/2011

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