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General NPI Number Information
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NPI Number | 1740321082
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Entity Type | Organization
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Legal Business Name | ROLIMAR, PSC.
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Dates
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Enumeration Date | 02/09/2007
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 3991 DUTCHMANS LN SUITE G03
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City | LOUISVILLE
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State | KY
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Zip | 40207-4700
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Country | US
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Telephone | 502-899-6100
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Fax | 502-899-6108
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | PROSPECT
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State | KY
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Zip | 40059-0847
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Country | US
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Telephone | 502-753-0680
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Fax | 502-753-0687
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. ROBERTO A. PENNE-CASANOVA
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Credential | M.D.
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Telephone | 502-899-6100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | 37074
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2083P0500X
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Taxonomy Name | Preventive Medicine/Occupational Environmental Medicine Physician
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License Number | 37074
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License Number State | KY
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