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General NPI Number Information
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NPI Number | 1447521612
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Entity Type | Organization
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Legal Business Name | CHERYL L ROBERSON MD PA
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 2352 CREEL LN SUITE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-4621
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Country | US
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Telephone | 813-615-9400
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Fax | 813-615-9403
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Provider Business Mailing Address
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Address Line | 2352 CREEL LN SUITE 102
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-4621
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Country | US
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Telephone | 813-615-9400
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Fax | 813-615-9403
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CHERYL ROBERSON
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Credential | M.D.
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Telephone | 813-615-9400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | ME67567
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License Number State | FL
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