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NPI Code Detail

MEDICARE: SUNY ROMAN APRN

MEDICARE: SUNY ROMAN APRN
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
1363LF0000XFamily Nurse PractitionerAPRN11026019FL
2208100000XPhysical Medicine & Rehabilitation PhysicianAPRN11026019FL
3363LP2300XPrimary Care Nurse Practitioner11026019FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437848512
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUNY ROMAN APRN
Provider Business Mailing Address
First Line : 1776 WOODSTEAD CT STE 208
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77380-1480
Country : US
Telephone Number : 877-749-7428
Fax Number :
Provider Business Practice Location Address
First Line : 3050 CHAMPION RING RD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-5599
Country : US
Telephone Number : 239-313-2900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2023
Last Update Date : 12/01/2025

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