Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 11006384 | FL |
NPI | 1033745211 |
---|---|
Provider Name | Barron Nicholas Roddey |
First Address | Tarpon Springs, FL 34689-6642 |
Second Address | Tarpon Springs, FL 34689-6642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2020 |
Last Update Date | 19/03/2020 |