Provider Demographics
NPI:1396905949
Name:ROBERTO, ANN J (ARNP)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:J
Last Name:ROBERTO
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 VETERANS PARK DR STE 260
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-0494
Mailing Address - Country:US
Mailing Address - Phone:239-624-0570
Mailing Address - Fax:239-254-7959
Practice Address - Street 1:1845 VETERANS PARK DR STE 260
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-0494
Practice Address - Country:US
Practice Address - Phone:239-624-0570
Practice Address - Fax:239-254-7959
Is Sole Proprietor?:No
Enumeration Date:2008-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9395228363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL014310000Medicaid
FLIB684ZOtherMEDICARE
FLY0Q64OtherBCBS