Healthcare Provider Details

I. General information

NPI: 1760546204
Provider Name (Legal Business Name): ALAN K ROBERTS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/20/2006
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 ISLAND AVE #2407
MIAMI BEACH FL
33139-1318
US

IV. Provider business mailing address

9 ISLAND AVE #2407
MIAMI BEACH FL
33139-1318
US

V. Phone/Fax

Practice location:
  • Phone: 305-632-2785
  • Fax: 305-672-2884
Mailing address:
  • Phone: 305-632-2785
  • Fax: 305-672-2884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberME30398
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: