MEDICARE: ROLAND E NIEMAN JR. MD

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	207RP1001X	Pulmonary Disease Physician	ME14644	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	91461	OTHER	HEALTH OPTIONS
2	4802012	OTHER	UNITED HEALTHCARE
3	91461	OTHER	BCBS
4	2145936	OTHER	AETNA
5	20550	OTHER	NEIGHBORHOOD HEALTH PLAN
6	1810144	OTHER	CIGNA

General Provider Information

NPI Number	:	1740279363
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROLAND E NIEMAN JR. MD

Provider Business Mailing Address
First Line	:	21110 BISCAYNE BLVD
Second Line	:	SUITE 303
City	:	AVENTURA
State	:	FL
Zip	:	33180-1227
Country	:	US
Telephone Number	:	305-466-0030
Fax Number	:	305-466-4755

Provider Business Practice Location Address
First Line	:	21110 BISCAYNE BLVD
Second Line	:	SUITE 303
City	:	AVENTURA
State	:	FL
Zip	:	33180-1227
Country	:	US
Telephone Number	:	305-466-0030
Fax Number	:	305-466-4755

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

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	07/09/2007

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Directions to “ ROLAND E NIEMAN JR. MD” Practice Location

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