Individual
JENNIFER L ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3030 EXECUTIVE DR, VENICE, FL 34292-2613
(941) 485-1505
(941) 485-7495
Mailing address
3030 EXECUTIVE DR, VENICE, FL 34292-2613
(941) 485-1505
(941) 485-7495
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA9102029
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
291421200
—
FL
Enumeration date
06/12/2006
Last updated
03/15/2024
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