ROLAND VAUGHN NPI 1093224388

NPI Information

  • NPI: 1093224388
  • Provider Name: ROLAND VAUGHN
  • Classification: Military Health Care Provider - 171000000X
  • Entity Type: Individual
  • Address: 970 LAKE CARILLON DR STE 300
    ST PETERSBURG, FL
    ZIP 33716
  • Phone: (303) 717-4336

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NPI Details

Roland Vaughn is a military health care provider in St Petersburg, FL. The provider is active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. Roland Vaughn NPI is 1093224388. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

970 LAKE CARILLON DR STE 300
ST PETERSBURG, FL
ZIP 33716-130
Phone: (303) 717-4336

The enumeration date for this NPI number is 9/29/2017 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1171000000XMilitary Health Care ProviderFLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
136510MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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