MEDICARE: MRS. MICHELLE PEREZ ROBERTS M.S., CCC SLP

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	235Z00000X	Speech-Language Pathologist	SA13198	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1861894099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MICHELLE PEREZ ROBERTS M.S., CCC SLP

Provider Business Mailing Address
First Line	:	3238 BENT OAK RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-2843
Country	:	US
Telephone Number	:	850-748-8283
Fax Number	:

Provider Business Practice Location Address
First Line	:	3238 BENT OAK RD
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32526-2843
Country	:	US
Telephone Number	:	850-748-8283
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 “ MRS. MICHELLE PEREZ ROBERTS M.S., CCC SLP” Practice Location

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