Provider Demographics
NPI:1528354313
Name:ROY, VENEETHA (ARNP)
Entity type:Individual
Prefix:
First Name:VENEETHA
Middle Name:
Last Name:ROY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4278 28TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33714-3922
Mailing Address - Country:US
Mailing Address - Phone:727-526-9135
Mailing Address - Fax:727-526-4346
Practice Address - Street 1:3475 E BAY DR
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:FL
Practice Address - Zip Code:33771-5905
Practice Address - Country:US
Practice Address - Phone:727-535-9700
Practice Address - Fax:727-539-7301
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9271277363LP0200X
NY382362363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics