Provider Demographics
NPI:1770069312
Name:ROBERTS, VILNA (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:VILNA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2053 N UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3936
Mailing Address - Country:US
Mailing Address - Phone:954-451-5578
Mailing Address - Fax:954-451-5208
Practice Address - Street 1:2053 N UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3936
Practice Address - Country:US
Practice Address - Phone:954-451-5578
Practice Address - Fax:954-451-5208
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL57438183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist