MEDICARE: LILIVETTE ROLLAND M.D.

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	208000000X	Pediatrics Physician	ME59316	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	IH-2280188	OTHER	FL	FIRST CARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	3939565	OTHER	FL	CIGNA
4	432062869	OTHER	FL	EVOLUTIONS HEALTHCARE
5	432062869	OTHER	FL	HUMANA
6	432062869	OTHER	FL	TRICARE
7	432062869	OTHER	FL	SOUTH CARE PPO
8	12802	OTHER	FL	BLUE CROSS/BLUE SHIELD
9	285461	OTHER	FL	WELLCARE/STAYWELL/HEALTHE
10	CCN-55	OTHER	FL	CCN
11	432062869	OTHER	FL	BAYCARE
12	432062869	OTHER	FL	PRIVATE HEALTH CARE
13	432062869	OTHER	FL	UNITED HEALTH CARE
14	278713	OTHER	FL	AMERIGROUP
15	3966308	OTHER	FL	AETNA
16	432062869	OTHER	FL	BEECH STREET CORP

General Provider Information

NPI Number	:	1831205103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILIVETTE ROLLAND M.D.

Provider Business Mailing Address
First Line	:	4602 N ARMENIA AVE
Second Line	:	SUITE A3
City	:	TAMPA
State	:	FL
Zip	:	33603-2626
Country	:	US
Telephone Number	:	813-873-1725
Fax Number	:

Provider Business Practice Location Address
First Line	:	4602 N ARMENIA AVE
Second Line	:	SUITE A 3
City	:	TAMPA
State	:	FL
Zip	:	33603-2626
Country	:	US
Telephone Number	:	813-873-1725
Fax Number	:	813-873-2924

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	12/06/2016

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Directions to “ LILIVETTE ROLLAND M.D.” Practice Location

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