| Organization Name: | A B ROA MEDICAL CENTER PA |
| NPI Number: | 1396934287 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTONIO B ROA (PRESIDENT) |
| Mailing Address: | 201 Us Highway 27 S Lake Placid |
| State: | FL US |
| Postal Code: | 338527904 |
| Phone Number: | 8634656200 |
| Fax Number: | 8634659217 |
| NPI Enumeration Date: | 10/17/2007 |
| NPI Last Update Date: | 10/17/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | ME0042772 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |