# A B ROA MEDICAL CENTER PA

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396934287
- **Authorized official:** DR. ANTONIO B ROA M.D. (PRESIDENT)
- **Authorized official phone:** (863) 465-6200

## Contact information

- **Practice address:** 201 US HIGHWAY 27 S, LAKE PLACID, FL 33852-7904
- **Practice address phone:** (863) 465-6200
- **Practice address fax:** (863) 465-9217
- **Mailing address:** PO BOX 2829, LAKE PLACID, FL 33862-2829
- **Mailing address phone:** (863) 465-6200
- **Mailing address fax:** (863) 465-9217

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | ME0042772 | FL | Yes |

## Other

- **Enumeration date:** 10/17/2007
- **Last updated:** 10/17/2007