MEDICARE: LINDA ROBERTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	286596	OH

General Provider Information

NPI Number	:	1083016349
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDA ROBERTS

Provider Business Mailing Address
First Line	:	2366 E 85TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3465
Country	:	US
Telephone Number	:	813-957-1075
Fax Number	:

Provider Business Practice Location Address
First Line	:	2366 E 85TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44106-3465
Country	:	US
Telephone Number	:	813-957-1075
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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Directions to “ LINDA ROBERTS ” Practice Location

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