Basic Information
| Provider Information | |||||||||
| NPI: | 1407011414 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ALTSCHULER | ||||||||
| FirstName: | ROBERTA | ||||||||
| MiddleName: | HELENE | ||||||||
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| Credential: | ARNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 CLEMATIS ST STE 5-531 | ||||||||
| Address2: | |||||||||
| City: | WEST PALM BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334015107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5616714043 | ||||||||
| FaxNumber: | 5618375190 | ||||||||
| Practice Location | |||||||||
| Address1: | 38754 STATE ROAD 80 | ||||||||
| Address2: | |||||||||
| City: | BELLE GLADE | ||||||||
| State: | FL | ||||||||
| PostalCode: | 334305615 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5619839220 | ||||||||
| FaxNumber: | 5619839320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2008 | ||||||||
| LastUpdateDate: | 08/22/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 364SW0102X | ARNP 1621552 | FL | Y | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 000348500 | 05 | FL | MEDICAID |