Provider Demographics
NPI:1841494499
Name:ROBERTI, JONATHAN (PHD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:ROBERTI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 S TAMIAMI TRL
Mailing Address - Street 2:SUITE C
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-3810
Mailing Address - Country:US
Mailing Address - Phone:941-993-4722
Mailing Address - Fax:
Practice Address - Street 1:2222 S TAMIAMI TRL
Practice Address - Street 2:SUITE C
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3810
Practice Address - Country:US
Practice Address - Phone:941-993-4722
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service
No246ZB0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherBiostatistician