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General NPI Number Information
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NPI Number | 1730322959
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Entity Type | Individual
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Provider Name | JENNIFER SUE ROBERTS P.T.
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Gender | Female
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Dates
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Enumeration Date | 04/17/2009
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 7447 N UNIVERSITY DR
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City | TAMARAC
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State | FL
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Zip | 33321-2970
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Country | US
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Telephone | 954-720-1530
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Fax |
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Provider Business Mailing Address
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Address Line | 363 NW 158TH AVE
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City | PEMBROKE PINES
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State | FL
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Zip | 33028-1587
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Country | US
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Telephone | 954-450-8715
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT0016563
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License Number State | FL
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