Healthcare Provider Details

I. General information

NPI: 1851645386
Provider Name (Legal Business Name): TAL ROBERTS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TAL JOHNSON N.P.

II. Dates (important events)

Enumeration Date: 11/06/2012
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10075 S JOG RD STE 206
BOYNTON BEACH FL
33437-3536
US

IV. Provider business mailing address

PO BOX 864719
ORLANDO FL
32886-4719
US

V. Phone/Fax

Practice location:
  • Phone: 561-737-1100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 9254588
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: