Provider Demographics
NPI:1801511647
Name:BANDIMERE, ROIANNE MARIE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ROIANNE
Middle Name:MARIE
Last Name:BANDIMERE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ROIANNE
Other - Middle Name:MARIE
Other - Last Name:TAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6567 E CARONDELET DR STE 415
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-6157
Mailing Address - Country:US
Mailing Address - Phone:520-887-7700
Mailing Address - Fax:
Practice Address - Street 1:6567 E CARONDELET DR STE 415
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-6157
Practice Address - Country:US
Practice Address - Phone:520-887-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-04
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9364207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty