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General NPI Number Information
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NPI Number | 1336134592
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Entity Type | Organization
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Legal Business Name | GEOFFREY ROBERTS, D.O.,P.A.
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 08/23/2011
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Provider Practice Location Address
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Address Line | 756 N SUNCOAST BLVD
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-9072
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Country | US
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Telephone | 352-795-5544
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Fax |
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Provider Business Mailing Address
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Address Line | 756 N SUNCOAST BLVD
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City | CRYSTAL RIVER
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State | FL
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Zip | 34429-9072
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Country | US
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Telephone | 352-795-5544
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | GEOFFREY ROBERTS
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Credential | D.O.
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Telephone | 352-795-5544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS4752
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License Number State | FL
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