Individual
DR. MICHAEL ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3620 N 55TH AVE, HOLLYWOOD, FL 33021-2344
(954) 964-8480
(754) 400-8543
Mailing address
3620 N 55TH AVE, HOLLYWOOD, FL 33021-2344
(954) 964-8480
(754) 400-8543
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
ME55375
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
064827200
—
FL
01
—
09847
BLUE CROSS BLUE SHIELD
FL
Enumeration date
05/23/2005
Last updated
03/30/2021
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