Provider Demographics
NPI:1982292785
Name:ALLEN, ROXANNE (PA-C)
Entity type:Individual
Prefix:
First Name:ROXANNE
Middle Name:
Last Name:ALLEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 GOODLETTE RD STE 500
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5656
Mailing Address - Country:US
Mailing Address - Phone:239-566-7676
Mailing Address - Fax:239-566-9149
Practice Address - Street 1:720 GOODLETTE RD STE 500
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5656
Practice Address - Country:US
Practice Address - Phone:239-566-7676
Practice Address - Fax:239-566-9149
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2025-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9115463363AM0700X
NY026161363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant