Healthcare Provider Details

I. General information

NPI: 1164495172
Provider Name (Legal Business Name): ROLAND JANIS ADAMSONS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 11/04/2024
Certification Date: 11/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E DIXIE AVE
LEESBURG FL
34748-5925
US

IV. Provider business mailing address

600 E DIXIE AVE
LEESBURG FL
34748-5925
US

V. Phone/Fax

Practice location:
  • Phone: 352-323-5762
  • Fax:
Mailing address:
  • Phone: 352-323-5762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number0420008769
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: