IndividualActive
Kaitlyn Roeder, PA
NPI 1083455182 · Physician Assistant · Brandon, FL
Provider details
- NPI number
- 1083455182
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- PA9121071 (FL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
5 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
414 W Robertson St
Brandon, FL 33511-5007
Phone: (813) 701-5804
Fax: (813) 291-7615
Street-level locationGet directions
Mailing address
Po Box 25201
Tampa, FL 33622-5201
Additional practice locations (4)
- 28050 US Highway 19 N Ste 100Clearwater, FL 33761-2600Phone: (813) 701-5804Fax: (813) 291-7615
- 2310 North Blvd W Ste aDavenport, FL 33837-8988Phone: (813) 701-5804Fax: (813) 291-7615
- 7032 US Highway 301 NEllenton, FL 34222-3030Phone: (813) 701-5804Fax: (813) 291-7615
- 1611 Harden BlvdLakeland, FL 33803-1826Phone: (813) 701-5804Fax: (813) 291-7615
Registry dates
- Enumerated
- 2024-06-03
- Last updated
- 2026-05-19
- Certified
- 2026-05-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.