ROLAND VAUGHN (NPI# 1093224388) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093224388 |
| Entity Type | Individual |
| Full Name | ROLAND VAUGHN |
| Practice Address |
970 Lake Carillon Dr Ste 300 St Petersburg FL 33716-1130 |
| Practice Telephone | (303) 717-4336 |
| Mailing Telephone | 3037174336 |
| Enumeration Date | 2017-09-29 |
| Last Update Date | 2017-10-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | FL | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 36510 | 05 |
| Street Address |
970 LAKE CARILLON DR STE 300 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33716-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689217747 | True North Health Navigation LLC | Emergency Medicine | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2019-10-22 |
| 1679057632 | Dispatchhealth-florida Pa | Emergency Medicine | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2018-09-17 |
| 1619475290 | Lucid Genetics, Corp. | Clinic/Center | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2018-01-29 |
| 1841700184 | Legacy Home Health LLC | Home Health | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2017-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699205815 | Orthopaedic Medical Group of Tampa Bay Pa | Clinic/Center | 10033 Mlk Jr St N Fl 3, St Petersburg, FL 33716 | 2017-06-20 |
| 1316471113 | Sara Alexandra Maltese | Dentist | 871 Ibis Walk Pl N Unit 7201, St Petersburg, FL 33716 | 2017-04-18 |
| 1508229972 | Florida Cardiac Therapeutics, Inc | Internal Medicine | 10033 Doctor M.l.k. Jr St N, Suite 302, St Petersburg, FL 33716 | 2016-04-01 |
| 1720440902 | Valorie Baker | Day Training, Developmentally Disabled Services | 115 112th Ave Ne Apt 627, St Petersburg, FL 33716 | 2016-03-25 |
| 1346611142 | Theresa Bowen | Occupational Therapist | 810 S. Village Drive N, #103, St. Petersburg, FL 33716 | 2015-10-19 |
| 1356775423 | Paula J Smith | Massage Therapist | 400 Carillon Pkwy #130, Mountain Tree Massage, LLC, St. Petersburg, FL 33716 | 2013-08-26 |
| 1699118596 | Kellie L Kintz | Social Worker | 540 Carillon Parkway, Apartment 3026, The Promenade At Carillon, St. Petersburg, FL 33716 | 2013-04-10 |
| 1427398288 | St. Petersburg General Hospital | General Acute Care Hospital | 11850 Doctor Martin Luther King Jr. St. North, Apt 22-312, St Petersburg, FL 33716 | 2013-02-15 |
| 1952657314 | Trudy Anna Glover | Occupational Therapy Assistant | 11850 9th Street North, Apt 20208, St Petersburg, FL 33716 | 2012-08-02 |
| 1275834129 | Prison Rehabilitative Industries & Diversified Enterprises | Dental Laboratory | 12425 28th St. N., Suite 300, St. Petersburg, FL 33716 | 2010-11-09 |
| Find all providers in zip 33716 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124294111 | Annelies Swarts Byington | Military Health Care Provider | 600 8th Ave Se, St Petersburg, FL 33701-5030 | 2008-04-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447872387 | Wesley Charles Wagers | Military Health Care Provider | 96 Mdos/sgof, 307 Boatner Road, Suite 114, Eglin Afb, FL 32542-1391 | 2020-05-14 |
| 1548808546 | Patrick S. Merriman | Military Health Care Provider | Navy Medicine Support Command Att: Medical Staff Svcs, Bldg H 2005 Knight Lane, Jacksonville, FL 32212-0140 | 2019-12-20 |
| 1023656451 | Operation Art District Healthcare LLC | Military Health Care Provider | 11 Nottingham Pl, Boynton Beach, FL 33426-8427 | 2019-12-17 |
| 1245881994 | Matthew Kerwin Church | Military Health Care Provider | 2020 Glenwood Hammock Rd, Deland, FL 32720-3805 | 2019-09-24 |
| 1326512443 | Francine Dorce I | Military Health Care Provider | 2300 Lynbrooke View Ct Apt 4, Orlando, FL 32822-4624 | 2019-01-12 |
| 1053805671 | Jeremy Ganz | Military Health Care Provider | 283 Twin Lakes Ln, Destin, FL 32541-2866 | 2018-06-18 |
| 1134644750 | Kwanza Lincoln | Military Health Care Provider | 3520 Zemke Ave, Tampa, FL 33621 | 2017-08-04 |
| 1134576390 | Nathan Jamal Pena | Military Health Care Provider | 1320 Bailey Ave, Jacksonville, FL 32228-0028 | 2016-05-18 |
| 1780063644 | Samuel Herman | Military Health Care Provider | Naval Hospital Pensacola 6000 Us-98, Pensacola, FL 32512-0001 | 2015-05-26 |
| 1659612240 | Andrew J Wright | Military Health Care Provider | Naval Hospital Pensacola 6000 Us-98 Hwy, Pensacola, FL 32512 | 2013-03-07 |
| Find all providers with the same taxonomy | ||||
| City | ST PETERSBURG |
| Zip Code | 33716 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.