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General NPI Number Information
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NPI Number | 1710239041
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Entity Type | Individual
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Provider Name | JONATHAN M. ROBERTS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 10/10/2012
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Last Update Date | 02/16/2014
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Provider Practice Location Address
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Address Line | 1835 FLORIDA CLUB CIR APT 3204
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City | NAPLES
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State | FL
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Zip | 34112-8729
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Country | US
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Telephone | 239-571-0814
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Fax |
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Provider Business Mailing Address
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Address Line | 1835 FLORIDA CLUB CIR APT 3204
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City | NAPLES
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State | FL
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Zip | 34112-8729
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Country | US
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Telephone | 239-571-0814
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PH27251
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS51460
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License Number State | FL
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