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General NPI Number Information
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NPI Number | 1699900928
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Entity Type | Individual
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Provider Name | JENNIFER ROBERTSON M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 3800 MEGGISON RD
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City | THE VILLAGES
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State | FL
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Zip | 32163-3028
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Country | US
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Telephone | 352-570-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 2368 HERSHEY LN
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City | THE VILLAGES
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State | FL
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Zip | 32163-1016
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Country | US
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Telephone | 304-671-5512
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 0101251546
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 24771
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | ME140463
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME140463
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License Number State | FL
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