Provider Demographics
NPI:1124042247
Name:ROBERTS, JOHN E III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:E
Last Name:ROBERTS
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:5700 N FEDERAL HWY
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308-2600
Mailing Address - Country:US
Mailing Address - Phone:954-491-6400
Mailing Address - Fax:954-771-8835
Practice Address - Street 1:5700 N FEDERAL HWY
Practice Address - Street 2:SUITE ONE
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308-2600
Practice Address - Country:US
Practice Address - Phone:954-491-6400
Practice Address - Fax:954-771-8835
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2010-07-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FL0068639208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020031374OtherRAILROAD MEDICARE
FL250732300Medicaid
FL20342OtherNEIGHBORHOOD HEALTH PARTN
FL27794OtherBLUE CROSS BLUE SHIELD
FL246691OtherAVMED
FL093066OtherCIGNA
FL020031374OtherRAILROAD MEDICARE
FL093066OtherCIGNA