Provider Demographics
NPI:1013188903
Name:ROBERTS, CHERYL JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:JEAN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 ESTRADA SQ
Mailing Address - Street 2:
Mailing Address - City:HOBE SOUND
Mailing Address - State:FL
Mailing Address - Zip Code:33455-2400
Mailing Address - Country:US
Mailing Address - Phone:772-546-3751
Mailing Address - Fax:772-545-0999
Practice Address - Street 1:100 ESTRADA SQ
Practice Address - Street 2:
Practice Address - City:HOBE SOUND
Practice Address - State:FL
Practice Address - Zip Code:33455-2400
Practice Address - Country:US
Practice Address - Phone:772-546-3751
Practice Address - Fax:772-546-7941
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 0058311207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE90620Medicare UPIN
FL12467YMedicare PIN
FL12467WMedicare PIN