Healthcare Provider Details

I. General information

NPI: 1376951400
Provider Name (Legal Business Name): MONICA ROBLES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2014
Last Update Date: 08/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5052 TAMIAMI TRL N STE C
NAPLES FL
34103-2835
US

IV. Provider business mailing address

5052 TAMIAMI TRL N STE C
NAPLES FL
34103-2835
US

V. Phone/Fax

Practice location:
  • Phone: 239-784-2297
  • Fax: 239-919-3358
Mailing address:
  • Phone: 239-784-2297
  • Fax: 239-919-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME103729
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberME103729
License Number StateFL

VIII. Authorized Official

Name: MS. MONICA ROBLES
Title or Position: OWNER/ PSYCHIATRIST
Credential: M.D.
Phone: 239-784-2297