Individual provider Active NPI

Traci Roa, CPT

  • Phlebotomy Technician
  • Alva, FL
National Provider Identifier
1639011190
Registry record updated Apr 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
M6X3B3B8 Issued in FL
Practice address
2244 Wolverton CT
Alva, FL 33920-1018
Phone
(239) 671-2763
NPI assigned
Apr 6, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X M6X3B3B8 FL Primary

Addresses

Primary practice location

2244 Wolverton CT
Alva, FL 33920-1018

Mailing address

2244 Wolverton CT
Alva, FL 33920-1018
Phone (239) 671-2763

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
M6X3B3B8FLMDPhlebotomy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1775433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1639011190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2244 WOLVERTON CT",
            "city": "ALVA",
            "state": "FL",
            "postal_code": "339201018",
            "telephone_number": "239-671-2763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2244 WOLVERTON CT",
            "city": "ALVA",
            "state": "FL",
            "postal_code": "339201018",
            "telephone_number": "239-671-2763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROA",
        "first_name": "TRACI",
        "credential": "CPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-06",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "FL",
            "license": "M6X3B3B8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alva, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.