Healthcare Provider Details

I. General information

NPI: 1649761628
Provider Name (Legal Business Name): MORGAN ROBERTSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MORGAN ROBERTSON MA-BCBA

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4085 HANCOCK BRIDGE PKWY STE 101
NORTH FORT MYERS FL
33903-7220
US

IV. Provider business mailing address

300 INTERNATIONAL PKWY STE 200
LAKE MARY FL
32746-5028
US

V. Phone/Fax

Practice location:
  • Phone: 239-677-3767
  • Fax: 239-236-8018
Mailing address:
  • Phone: 833-288-4761
  • Fax: 407-588-6294

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-19-35715
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: