Healthcare Provider Details

I. General information

NPI: 1194088666
Provider Name (Legal Business Name): MICHELE T ROBERTS-PERKINS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 12/14/2021
Certification Date: 12/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7649 W COLONIAL DR STE 115
ORLANDO FL
32818-7423
US

IV. Provider business mailing address

PO BOX 616788
ORLANDO FL
32861-6788
US

V. Phone/Fax

Practice location:
  • Phone: 407-522-2080
  • Fax: 833-963-0115
Mailing address:
  • Phone: 407-447-7120
  • Fax: 407-770-0661

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9250113
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: