MEDICARE: JAMIE A ROBERTS LPN

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	164W00000X	Licensed Practical Nurse	PN520331	FL

General Provider Information

NPI Number	:	1679405427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMIE A ROBERTS LPN

Provider Business Mailing Address
First Line	:	6214 SHINER ST
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-5776
Country	:	US
Telephone Number	:	727-235-7223
Fax Number	:

Provider Business Practice Location Address
First Line	:	6214 SHINER ST
Second Line	:
City	:	LAND O LAKES
State	:	FL
Zip	:	34638-5776
Country	:	US
Telephone Number	:	727-235-7223
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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