Healthcare Provider Details

I. General information

NPI: 1386570083
Provider Name (Legal Business Name): NATHALIE ROUMI
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2026
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 AVENUE F NE
WINTER HAVEN FL
33881-4193
US

IV. Provider business mailing address

901 WATERSIDE LN APT 209
KISSIMMEE FL
34747-4870
US

V. Phone/Fax

Practice location:
  • Phone: 863-293-1121
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS66204
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: