Healthcare Provider Details

I. General information

NPI: 1871900381
Provider Name (Legal Business Name): PATRICIA ROXAS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2014
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 COLONNADE DR STE 230
PONTE VEDRA FL
32081-6237
US

IV. Provider business mailing address

800 PRUDENTIAL DR
JACKSONVILLE FL
32207-8202
US

V. Phone/Fax

Practice location:
  • Phone: 904-652-0800
  • Fax: 904-652-0811
Mailing address:
  • Phone: 904-202-2963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9269255
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: