Provider Demographics
NPI:1992921977
Name:REXROTH, ROBERTA K (ARNP)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:K
Last Name:REXROTH
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 1:9256 BIRMINGHAM AVE
Mailing Address - Street 2:
Mailing Address - City:WEEKI WACHEE
Mailing Address - State:FL
Mailing Address - Zip Code:34613-4424
Mailing Address - Country:US
Mailing Address - Phone:352-596-0907
Mailing Address - Fax:352-597-5270
Practice Address - Street 1:4644 KEYSVILLE AVE
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34608-3515
Practice Address - Country:US
Practice Address - Phone:352-666-4216
Practice Address - Fax:352-666-4216
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL912712-ARNP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health