Provider Demographics
NPI:1154840676
Name:ROLIN, DENO DUSTIN (MD, DNP, APRN)
Entity type:Individual
Prefix:DR
First Name:DENO
Middle Name:DUSTIN
Last Name:ROLIN
Suffix:
Gender:M
Credentials:MD, DNP, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 HIGHWAY 97
Mailing Address - Street 2:
Mailing Address - City:WALNUT HILL
Mailing Address - State:FL
Mailing Address - Zip Code:32568-2017
Mailing Address - Country:US
Mailing Address - Phone:954-439-8723
Mailing Address - Fax:
Practice Address - Street 1:8100 N DAVIS HWY
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32514
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-15
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHSE27055208D00000X
KS77877363LF0000X
AL3-001006363LF0000X
FL9418362363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice