Individual
MARY ALICE GALLANT-ROMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 844-8523
(813) 844-8047
Mailing address
1 TAMPA GENERAL CIR, TAMPA, FL 33606-3571
(813) 844-8523
(813) 844-8047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
ARNP3286052
FL
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP3286052
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023857700
—
FL
01
—
DG1O5
BLUE CROSS BLUE SHIELD
FL
Enumeration date
07/26/2010
Last updated
03/31/2021
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