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General NPI Number Information
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NPI Number | 1689660227
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Entity Type | Individual
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Provider Name | EDWARD J ROBERTS P.A.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2005
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 1770 NE MIAMI GDN DR
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33179-5301
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Country | US
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Telephone | 810-686-2600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 585
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City | OXFORD
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State | MI
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Zip | 48371-0585
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Country | US
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Telephone | 248-969-3220
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Fax | 844-274-3091
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9114582
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License Number State | FL
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