Maryna Nikolayevna Roberts, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME106791 Issued in FL

Practice address

1400 Colonial Blvd
Suite 203
Fort Myers, FL 33907-1055

Phone

(239) 938-9184

Fax

(239) 313-4687

NPI assigned

Dec 18, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Internal Medicine Associates of Lee County MD PA

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1972565919
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480896000000",
    "number": "1265616809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13607 PINE VILLA LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121617",
            "telephone_number": "239-424-3123",
            "fax_number": "239-424-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 COLONIAL BLVD",
            "address_2": "SUITE 203",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071055",
            "telephone_number": "239-938-9184",
            "fax_number": "239-313-4687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARYNA",
        "middle_name": "NIKOLAYEVNA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-18",
        "last_updated": "2016-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME106791",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "26076",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jade Roberts
• Jaime Roberts
• Katherine Jo Roberts, PA-C
• Madeline Kay Roberts
• Marissa Roberts, APRN-NP
• Morgan Ann Roberts, RD
• Tamarae A Roberts
• Monique Robertson
• Jeffrey B Robin, M.D.
• Frances Robine, ARNP

• Family Medicine Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.