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Roland Vaughn
Military Health Care Provider in St Petersburg, Florida
NPI 1093224388

Roland Vaughn is a Military Health Care Provider based in St Petersburg, FL. Roland Vaughn practices in St Petersburg, FL. The NPI Number for Roland Vaughn is 1093224388 and holds a License No. (Florida).

The current practice location address for Roland Vaughn is 970 Lake Carillon Dr Ste 300, St Petersburg, FL and can be reached out via phone at 303-717-4336.

Location: 970 Lake Carillon Dr Ste 300, St Petersburg, FL, 33716-1130
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1093224388
Provider Name
Roland Vaughn
Credential
Provider Entity Type
Individual
Gender
Male
Address
970 Lake Carillon Dr Ste 300, St Petersburg, FL, 33716-1130
Phone Number
303-717-4336
Fax Number
Provider Enumeration Date
09/29/2017
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
36510 05 FL
institution
Provider Business Practice Location Address Details
Address
970 Lake Carillon Dr Ste 300
City
St Petersburg
State
Florida
Zip
33716-1130
Phone Number
303-717-4336
Fax Number
person
Provider Business Mailing Address Details
Address
970 Lake Carillon Dr Ste 300
City
St Petersburg
State
Florida
Zip
33716-1130
Phone Number
303-717-4336
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
(Florida)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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