Individual
MR. JUSTIN LANE ROARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4141 TRANSUE DRIVE, ZEPHYRHILLS, FL 33542
(501) 612-0065
Mailing address
4141 TRANSUE DR, ZEPHYRHILLS, FL 33542-7358
(501) 612-0065
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9420912
FL
Other
Enumeration date
05/10/2018
Last updated
05/10/2018
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