Provider Demographics
NPI:1346124062
Name:ROSCOE, PAIGE ALLISON (DNP, APRN, AGNP-C)
Entity type:Individual
Prefix:DR
First Name:PAIGE
Middle Name:ALLISON
Last Name:ROSCOE
Suffix:
Gender:F
Credentials:DNP, APRN, AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 SHORECREST AVE
Mailing Address - Street 2:
Mailing Address - City:DELTONA
Mailing Address - State:FL
Mailing Address - Zip Code:32725-7621
Mailing Address - Country:US
Mailing Address - Phone:978-855-9977
Mailing Address - Fax:
Practice Address - Street 1:7300 SANDLAKE COMMONS BLVD STE 127
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819-8011
Practice Address - Country:US
Practice Address - Phone:321-841-4344
Practice Address - Fax:321-843-6947
Is Sole Proprietor?:No
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9525261163W00000X
MARN2328123163W00000X
FLAPRN11019554363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse