Provider Demographics
NPI:1669467254
Name:ROBERTO, FRANK ANDRE (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANK
Middle Name:ANDRE
Last Name:ROBERTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 INDEPENDENCE BLVD
Mailing Address - Street 2:SUIT 245
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5493
Mailing Address - Country:US
Mailing Address - Phone:757-385-0684
Mailing Address - Fax:757-493-5456
Practice Address - Street 1:289 INDEPENDENCE BLVD
Practice Address - Street 2:SUIT 245
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5493
Practice Address - Country:US
Practice Address - Phone:757-385-0684
Practice Address - Fax:757-493-5456
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010333722084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540990270OtherMAGELLAN
VA654878OtherMAMSI - PEDIATRIC
VA540990270OtherUNITED HEALTH CARE & UBH
VAC03534OtherMEDICARE GROUP C03534
VA004945310OtherVIRGINIA PREMIER
VA954878OtherMAMSI - ADULT
VAO87780OtherOPTIMA FAMILY CARE
VA540990270OtherVICARE
VA1861562472Medicaid
VA393066OtherTRIGON BCBS/HEALTHKEEPERS
VA7112807Medicaid
VA654878OtherMAMSI - PEDIATRIC
VA7112807Medicaid