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General NPI Number Information
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NPI Number | 1427115880
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Entity Type | Individual
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Provider Name | ROSLYN DELORES THOMPSON D.C.
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 10/30/2009
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Provider Practice Location Address
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Address Line | 4100 EDGEWATER DR
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City | ORLANDO
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State | FL
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Zip | 32804-2205
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Country | US
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Telephone | 407-293-8890
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Fax | 407-293-8891
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Provider Business Mailing Address
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Address Line | 4724 DOBERMAN ST
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City | ORLANDO
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State | FL
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Zip | 32818-8724
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Country | US
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Telephone | 407-295-9572
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Fax | 407-295-9572
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH8368
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 1757532
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License Number State | FL
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