Healthcare Provider Details

I. General information

NPI: 1982292785
Provider Name (Legal Business Name): ROXANNE ALLEN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2021
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 GOODLETTE RD STE 500
NAPLES FL
34102-5656
US

IV. Provider business mailing address

720 GOODLETTE RD STE 500
NAPLES FL
34102-5656
US

V. Phone/Fax

Practice location:
  • Phone: 239-566-7676
  • Fax: 239-566-9149
Mailing address:
  • Phone: 239-566-7676
  • Fax: 239-566-9149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA9115463
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number026161
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: