Individual
MELBA MARIA ROA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9861 E. FERN STREET, PALMETTO BAY, FL 33157
(305) 534-0076
Mailing address
1400 NW 107TH AVE STE 500, SWEETWATER, FL 33172-2746
(305) 534-0076
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
ME72456
FL
208D00000X
General Practice Physician
Primary
ME72456
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100175000
—
FL
01
—
JO015
MEDICARE
FL
Enumeration date
05/10/2006
Last updated
09/07/2021
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