Healthcare Provider Details

I. General information

NPI: 1396715744
Provider Name (Legal Business Name): ROBERT S ROBERTS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 04/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N ORANGE AVE STE 600
ORLANDO FL
32801-5202
US

IV. Provider business mailing address

801 N ORANGE AVE STE 600
ORLANDO FL
32801-5202
US

V. Phone/Fax

Practice location:
  • Phone: 407-841-2100
  • Fax: 407-841-5705
Mailing address:
  • Phone: 407-841-2100
  • Fax: 407-841-5705

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME0041010
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberME0041010
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: