Healthcare Provider Details

I. General information

NPI: 1932132586
Provider Name (Legal Business Name): ROMAN AMABLE GASTESI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 06/07/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

816 NE 20TH AVE
FT LAUDERDALE FL
33304-3036
US

IV. Provider business mailing address

816 NE 20TH AVE
FT LAUDERDALE FL
33304-3036
US

V. Phone/Fax

Practice location:
  • Phone: 954-463-0070
  • Fax: 954-463-7014
Mailing address:
  • Phone: 954-463-0070
  • Fax: 954-463-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberME17960
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: