Individual
MRS. ANGELA S ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11 RIVERSIDE DR, SUITE 200, COCOA, FL 32922-7840
(321) 221-7447
(321) 221-7448
Mailing address
11 RIVERSIDE DR, SUITE 200, COCOA, FL 32922-7840
(321) 221-7447
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
10000258A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005813400
—
FL
Enumeration date
03/22/2006
Last updated
06/10/2016
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