Provider Demographics
NPI:1316351190
Name:ROBERTSON AND ASSOCIATES LLC
Entity type:Organization
Organization Name:ROBERTSON AND ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:F
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:PH D
Authorized Official - Phone:407-297-1185
Mailing Address - Street 1:4019 CLARCONA OCOEE RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32810-4270
Mailing Address - Country:US
Mailing Address - Phone:407-297-1185
Mailing Address - Fax:888-694-3421
Practice Address - Street 1:4019 CLARCONA OCOEE RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32810-4270
Practice Address - Country:US
Practice Address - Phone:407-297-1185
Practice Address - Fax:888-694-3421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY8017103T00000X
251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty