Organization
BABA HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DIANE CAROL ROBERSON (INSURANCE CREDENTAILING)
(321) 956-7370
Entity
Organization
Contact information
Practice address
948 S WICKHAM RD, STE, W MELBOURNE, FL 32904-1647
(321) 956-7370
(321) 956-7873
Mailing address
948 S WICKHAM RD, STE 103, W MELBOURNE, FL 32904-1647
(321) 956-7370
(321) 956-7873
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
ARNP 9179052
FL
Other
Enumeration date
02/27/2015
Last updated
02/27/2015
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