| Roberta A. Mix, D.o., P.a. | |
|
2102 Trinity Oaks Blvd Suite 201 Trinity FL 34655-4409 | |
| (727) 376-8885 | |
| (727) 376-7997 |
| Full Name | Roberta A. Mix, D.o., P.a. |
|---|---|
| Speciality | Family Medicine |
| Location | 2102 Trinity Oaks Blvd, Trinity, Florida |
| Authorized Official Name and Position | Roberta Ann Mix (PRESIDENT) |
| Authorized Official Contact | 7273768885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roberta A. Mix, D.o., P.a. 2102 Trinity Oaks Blvd Suite 201 Trinity FL 34655-4409 Ph: (727) 376-8885 | Roberta A. Mix, D.o., P.a. 2102 Trinity Oaks Blvd Suite 201 Trinity FL 34655-4409 Ph: (727) 376-8885 |
| NPI Number | 1831282110 |
|---|---|
| Provider Enumeration Date | 10/01/2006 |
| Last Update Date | 11/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831282110 | NPI | - | NPPES |
| 2563461-00 | Medicaid | FL | |
| 4867933001 | Other | FL | DME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OS7532 (Florida) | Primary |
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