Healthcare Provider Details

I. General information

NPI: 1235057159
Provider Name (Legal Business Name): SHANA NICOLE ROTMAN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 S FEDERAL HWY STE J
DELRAY BEACH FL
33483-3321
US

IV. Provider business mailing address

3015 S OCEAN BLVD APT 5D
HIGHLAND BEACH FL
33487-1855
US

V. Phone/Fax

Practice location:
  • Phone: 561-894-5300
  • Fax:
Mailing address:
  • Phone: 954-661-4318
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2026055434
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: