Provider Demographics
NPI:1326083171
Name:ROZIN, ROMAN (MD)
Entity Type:Individual
Prefix:
First Name:ROMAN
Middle Name:
Last Name:ROZIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 S TAMIAMI TRL
Mailing Address - Street 2:1250 MEDICAL PLAZA STE 103
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2207
Mailing Address - Country:US
Mailing Address - Phone:941-951-2100
Mailing Address - Fax:941-951-2110
Practice Address - Street 1:1250 S TAMIAMI TRL
Practice Address - Street 2:1250 MEDICAL PLAZA STE 103
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2207
Practice Address - Country:US
Practice Address - Phone:941-951-2100
Practice Address - Fax:941-951-2110
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME815742085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL262988700Medicaid