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NPI Code Detail

MEDICARE: MR. SHAWN D ROBERTS RBT

MEDICARE: MR. SHAWN D ROBERTS RBT
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
1106S00000XBehavior TechnicianRBT-15-09140FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114496692
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SHAWN D ROBERTS RBT
Provider Business Mailing Address
First Line : 8 WILDWOOD LN
Second Line :
City : PALM COAST
State : FL
Zip : 32137-3221
Country : US
Telephone Number : 386-227-6485
Fax Number : 866-247-1790
Provider Business Practice Location Address
First Line : 8 WILDWOOD LN
Second Line :
City : PALM COAST
State : FL
Zip : 32137-3221
Country : US
Telephone Number : 386-227-6485
Fax Number : 866-247-1790
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2018
Last Update Date : 01/29/2026

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