Provider Demographics
NPI:1316811151
Name:ROMAN, PABLO (RN)
Entity type:Individual
Prefix:
First Name:PABLO
Middle Name:
Last Name:ROMAN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:PABLO
Other - Middle Name:
Other - Last Name:AYALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14844 SUMMER BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:LITHIA
Mailing Address - State:FL
Mailing Address - Zip Code:33547-5130
Mailing Address - Country:US
Mailing Address - Phone:786-314-6348
Mailing Address - Fax:
Practice Address - Street 1:14844 SUMMER BRANCH DR
Practice Address - Street 2:
Practice Address - City:LITHIA
Practice Address - State:FL
Practice Address - Zip Code:33547-5130
Practice Address - Country:US
Practice Address - Phone:786-314-6348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9637403163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse