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General NPI Number Information
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NPI Number | 1962630004
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Entity Type | Individual
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Provider Name | ERIC JUSTIN ROBERTS DPM
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Gender | Male
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Dates
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Enumeration Date | 06/28/2009
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Last Update Date | 12/18/2024
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Provider Practice Location Address
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Address Line | 2026 5TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33713-8078
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Country | US
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Telephone | 727-954-5525
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Fax | 888-229-0143
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Provider Business Mailing Address
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Address Line | 2026 5TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33713-8078
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Country | US
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Telephone | 727-954-5525
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Fax | 888-229-0143
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | PO3551
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | P77589
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC006136
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License Number State | PA
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