Provider Demographics
NPI:1174036420
Name:ROBERTSON, LAUREN (ARNP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 COLONIAL DR STE 403
Mailing Address - Street 2:
Mailing Address - City:MARGATE
Mailing Address - State:FL
Mailing Address - Zip Code:33063-5663
Mailing Address - Country:US
Mailing Address - Phone:954-803-9002
Mailing Address - Fax:954-933-2305
Practice Address - Street 1:5800 COLONIAL DR STE 403
Practice Address - Street 2:
Practice Address - City:MARGATE
Practice Address - State:FL
Practice Address - Zip Code:33063-5663
Practice Address - Country:US
Practice Address - Phone:954-803-9002
Practice Address - Fax:954-933-2305
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-08
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9334029363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily