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NPI Code Detail

MEDICARE: DR. ROMAN S BAUTISTA DO

MEDICARE: DR. ROMAN S BAUTISTA DO
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
1207R00000XInternal Medicine PhysicianOS007158FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
159067672OTHERFLBSAL
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
371 58377OTHERFLAETNA
462842OTHERFLBSFL

General Provider Information

NPI Number : 1376528380
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROMAN S BAUTISTA DO
Provider Business Mailing Address
First Line : 7000 COBBLE CRK
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-8638
Country : US
Telephone Number : 850-776-4265
Fax Number :
Provider Business Practice Location Address
First Line : 7000 COBBLE CRK
Second Line :
City : PENSACOLA
State : FL
Zip : 32504-8638
Country : US
Telephone Number : 850-776-4265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 04/28/2011

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