Individual
VERNON ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
818 MARQUIS CT, KISSIMMEE, FL 34759-3828
(646) 353-9320
Mailing address
818 MARQUIS CT, KISSIMMEE, FL 34759-3828
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2020
Last updated
08/03/2020
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