Roberta Ann Mix, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS7532 Issued in FL

Practice address

2102 Trinity Oaks Blvd
Suite 201
Trinity, FL 34655-4409

Phone

(727) 376-8885

Fax

(727) 376-7997

NPI assigned

Oct 1, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1159660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408406400000",
    "number": "1851484133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 EISENHOWER BLVD",
            "address_2": "SUITE 300",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336346344",
            "telephone_number": "813-636-2000",
            "fax_number": "727-376-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2102 TRINITY OAKS BLVD",
            "address_2": "SUITE 201",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346554409",
            "telephone_number": "727-376-8885",
            "fax_number": "727-376-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIX",
        "first_name": "ROBERTA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-01",
        "last_updated": "2014-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS7532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080147946",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "011909200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hayley Miller
• Rory Elizabeth Mills, MD
• Mikel James Mineo, APRN
• Minimally Invasive Surgical Specialists
• Lindsay Mischler, PMHNP-BC
• Erin Mockler Eaton
• William Cody Montgomery, OT
• Dan P. Montzka, MD
• Ryan Myles Moran, MD
• Maria Angela Moreno, M.D.

• Family Medicine Physician in Trinity, FL
• Providers in Trinity, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2014; 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.