Provider Demographics
NPI:1447486758
Name:JOSHUA ROBERTS DPM LLC
Entity type:Organization
Organization Name:JOSHUA ROBERTS DPM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:COLLINS
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:863-357-1166
Mailing Address - Street 1:235 NE 19TH DR
Mailing Address - Street 2:
Mailing Address - City:OKEECHOBEE
Mailing Address - State:FL
Mailing Address - Zip Code:34972-1933
Mailing Address - Country:US
Mailing Address - Phone:863-357-1166
Mailing Address - Fax:863-357-0424
Practice Address - Street 1:235 NE 19TH DR
Practice Address - Street 2:
Practice Address - City:OKEECHOBEE
Practice Address - State:FL
Practice Address - Zip Code:34972-1933
Practice Address - Country:US
Practice Address - Phone:863-357-1166
Practice Address - Fax:863-357-0424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-02
Last Update Date:2010-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric