Healthcare Provider Details

I. General information

NPI: 1073165023
Provider Name (Legal Business Name): PAMELA M ROBERTS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2019
Last Update Date: 07/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N MIAMI BEACH BLVD STE 1&2
N MIAMI BEACH FL
33162-3720
US

IV. Provider business mailing address

1540 NW 203RD ST
MIAMI FL
33169-2347
US

V. Phone/Fax

Practice location:
  • Phone: 305-919-7399
  • Fax: 305-919-7424
Mailing address:
  • Phone: 305-788-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS39370
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: