MEDICARE: DIANA ROMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	ME134618	FL

General Provider Information

NPI Number	:	1124412564
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA ROMAN

Provider Business Mailing Address
First Line	:	601 S HARBOUR ISLAND BLVD STE 200
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33602-5925
Country	:	US
Telephone Number	:	727-322-3439
Fax Number	:	800-928-7449

Provider Business Practice Location Address
First Line	:	4250 BEE RIDGE RD
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34233-2563
Country	:	US
Telephone Number	:	941-926-8855
Fax Number	:	844-388-6186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2015
Last Update Date	:	04/08/2026

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Directions to “ DIANA ROMAN ” Practice Location

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