Provider Demographics
NPI:1922053594
Name:ROONEY, JAMES J (ARNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:ROONEY
Suffix:
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 TALL PINE CIR
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5204
Mailing Address - Country:US
Mailing Address - Phone:727-725-5678
Mailing Address - Fax:727-725-5678
Practice Address - Street 1:1701 TALL PINE CIR
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-5204
Practice Address - Country:US
Practice Address - Phone:727-725-5678
Practice Address - Fax:727-725-5678
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2949142363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLQ42477Medicare UPIN
FLU4662AMedicare PIN