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General NPI Number Information
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NPI Number | 1376941930
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Entity Type | Individual
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Provider Name | ALVIN ROBERTSON
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Gender | Male
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Dates
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Enumeration Date | 12/15/2014
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 931 VILLAGE BLVD, SUITE 905-358
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City | WEST PALM BEACH
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State | FL
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Zip | 33409-1803
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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Provider Business Mailing Address
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Address Line | 4575 SE DIXIE HWY
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City | STUART
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State | FL
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Zip | 34997-6826
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Country | US
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Telephone | 855-832-6727
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Fax | 772-675-9100
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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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 12155452
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License Number State | FL
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