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General NPI Number Information
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NPI Number | 1174586416
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Entity Type | Individual
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Provider Name | MS. DEBORAH B ROBERTSON
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Gender | Female
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 7230 S LAKE JOANNA DR
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City | PANAMA CITY
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State | FL
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Zip | 32404-4071
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Country | US
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Telephone | 850-785-3843
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Fax |
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Provider Business Mailing Address
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Address Line | 7230 S LAKE JOANNA DR
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City | PANAMA CITY
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State | FL
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Zip | 32404-4071
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Country | US
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Telephone | 850-785-3843
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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