Male or Other

Mr. Thomas G. Roberts PA-C

Medical Physician Assistant in Miramar Beach, FL(View on Map)

Full Name

Mr. Thomas G Roberts PA-C

NPI Number

1205859857

NPI Type

Individual Provider

Gender

Male

Enumeration Date

07/25/2006

Specialties

(Taxonomies)

Code

363AM0700X

Primary Taxonomy

Yes

Licenses

State

Florida

License Number

PA 3482

Contact
Information

Purpose

Mailing
Location

Address

12671 EMERALD COAST PKWY W UNIT 215
12671 EMERALD COAST PKWY W

City

Miramar Beach
Miramar Beach

State

FL
FL

Postal Code

32550-8304
32550-8300

Country

US
US

Telephone Number

(850) 424-7170
(850) 424-7170

Identifiers

Identifier

PA0003482

Identifier State

FL

Identifier Issuer

STATE LICENSE NUMBER

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/15/2011

Provider Address

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