Individual
NICOLE ALICIA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 TAMPA GENERAL CIR FL 6, TAMPA, FL 33606-3603
(813) 259-8542
Mailing address
PO BOX 917770, ORLANDO, FL 32891-0001
(813) 974-2201
(813) 974-2812
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
ME136192
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175600
—
FL
01
—
D57B9
BLUE CROSS BLUE SHIELD
FL
Enumeration date
06/09/2014
Last updated
10/22/2020
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