Killeen, Roberta Marie

Killeen, Roberta Marie is an sole proprietor health care provider with primary practice located at 2520 Us Highway 19 , Holiday FL 34691-3846. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology, which is considered as her primary health care specialty. Killeen, Roberta Marie can be contacted via phone (727) 934-6905.

Contact Information

Primary practice address
2520 Us Highway 19 Holiday FL 34691-3846
Phone: (727) 934-6905
Fax: (727) 934-4045
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X ME58665 Florida

Profile Details

NPI number 1245222447
LBN Legal business name Killeen, Roberta Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 16th, 2005
Last updated Sep 19th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245222447 NPPES
Florida MEDICAID 052961300

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