Healthcare Provider Details

I. General information

NPI: 1932105566
Provider Name (Legal Business Name): ROMAN THOMAS PACHULSKI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2005
Last Update Date: 03/22/2026
Certification Date: 03/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

IV. Provider business mailing address

200 SE HOSPITAL AVE
STUART FL
34994-2346
US

V. Phone/Fax

Practice location:
  • Phone: 772-287-5200
  • Fax:
Mailing address:
  • Phone: 772-287-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number220668
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberME156329
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberL9413
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberME156329
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: