Individual
ROBERTA PIERRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10960 BEACH BLVD LOT 32, JACKSONVILLE, FL 32246-4831
(904) 328-6904
(904) 328-6946
Mailing address
10960 BEACH BLVD LOT 32, JACKSONVILLE, FL 32246-4831
(904) 328-6904
(904) 328-6946
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
233862
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011682200
—
FL
Enumeration date
04/29/2015
Last updated
04/29/2015
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