Healthcare Provider Details

I. General information

NPI: 1972435808
Provider Name (Legal Business Name): TARIA MARGARETTA ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 BOSTON AVE
ALTAMONTE SPRINGS FL
32701-4731
US

IV. Provider business mailing address

11612 COLLEGE PARK TRL APT 21-Q
ORLANDO FL
32826-3900
US

V. Phone/Fax

Practice location:
  • Phone: 844-573-0669
  • Fax:
Mailing address:
  • Phone: 803-597-9808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: