Provider Demographics
NPI:1629088927
Name:ROBERTS, HEIDI D (AUD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:D
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13999 GULF BLVD
Mailing Address - Street 2:SUITE C-4
Mailing Address - City:MADEIRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33708-2648
Mailing Address - Country:US
Mailing Address - Phone:727-329-8683
Mailing Address - Fax:
Practice Address - Street 1:13999 GULF BLVD
Practice Address - Street 2:SUITE C-4
Practice Address - City:MADEIRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33708-2648
Practice Address - Country:US
Practice Address - Phone:727-329-8683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAY1366231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist