Provider Demographics
NPI:1285748202
Name:ROBERTS, HUGH H (DC)
Entity type:Individual
Prefix:DR
First Name:HUGH
Middle Name:H
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W CHRISTINA BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3508
Mailing Address - Country:US
Mailing Address - Phone:863-682-1170
Mailing Address - Fax:863-682-1084
Practice Address - Street 1:201 W CHRISTINA BLVD
Practice Address - Street 2:SUITE 1
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3508
Practice Address - Country:US
Practice Address - Phone:863-682-1170
Practice Address - Fax:863-682-1084
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH2953111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician