Individual
MR. DOUGLAS W ROANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2100 KINGSLEY AVE, ORANGE PARK, FL 32073
(904) 276-0001
Mailing address
2100 KINGSLEY AVE, ORANGE PARK, FL 32073-5130
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
ME128287
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000019111
BCBS OF MT
MT
05
—
0018037
—
MT
01
—
ZT66G
FLORIDA BLUE
FL
Enumeration date
09/17/2006
Last updated
04/04/2019
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