MR. Shane William Roback, PA-C

NPI #1760331524 in Venice, Florida

Provider Information

NPI Number: 1760331524
Entity Type: Individual
Name: MR. Shane William Roback, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jan 26, 2026
Last Updated: Jan 26, 2026

Practice Location

Address: 19920 BRIDGETOWN LOOP
City: Venice
State: Florida
ZIP Code: 34293-2281
Phone: (315) 793-0816

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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