Medrano, Roger Charles

Medrano, Roger Charles is an sole proprietor health care provider with primary practice located at 1111 N West Shore Blvd 109-A, Tampa FL 33607-4703. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, which is considered as his primary health care specialty. Medrano, Roger Charles can be contacted via phone (813) 286-2125.

Contact Information

Primary practice address
1111 N West Shore Blvd 109-A Tampa FL 33607-4703
Phone: (813) 286-2125
Fax: (813) 514-4103
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X MA33167 Florida

Profile Details

NPI number 1356489306
LBN Legal business name Medrano, Roger Charles
Credentials L.M.T.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 2nd, 2007
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356489306 NPPES
Florida MEDICAID 681954100

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