Healthcare Provider Details

I. General information

NPI: 1548803737
Provider Name (Legal Business Name): ANNA ROY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/21/2019
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7441 114TH AVE STE 604
LARGO FL
33773-5124
US

IV. Provider business mailing address

12069 CITRUS FALLS CIR APT 101
TAMPA FL
33625-5736
US

V. Phone/Fax

Practice location:
  • Phone: 727-492-5369
  • Fax: 727-544-5900
Mailing address:
  • Phone: 863-899-5779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-78128
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: