Provider Demographics
NPI:1952577785
Name:ROMAN, JOSEPH J (RPH)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:ROMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7710 261ST ST E
Mailing Address - Street 2:
Mailing Address - City:MYAKKA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:34251-5184
Mailing Address - Country:US
Mailing Address - Phone:941-322-1966
Mailing Address - Fax:941-727-8195
Practice Address - Street 1:7290 55 AVE E
Practice Address - Street 2:PUBLIX PHARMACY #491
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34203-8002
Practice Address - Country:US
Practice Address - Phone:941-727-8412
Practice Address - Fax:941-727-8195
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS15220183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist