Provider Demographics
NPI:1124246061
Name:ROMBRO, TALI (DO)
Entity type:Individual
Prefix:
First Name:TALI
Middle Name:
Last Name:ROMBRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 N. UNIVERSITY DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071
Mailing Address - Country:US
Mailing Address - Phone:954-755-1411
Mailing Address - Fax:954-755-8315
Practice Address - Street 1:1801 N. UNIVERSITY DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33071
Practice Address - Country:US
Practice Address - Phone:954-755-1411
Practice Address - Fax:954-755-8315
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS10025207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL278843800Medicaid
109515OtherUSA/MCO
FL10476OtherBLUE CROSS BLUE SHIELD
FLAF440ZMedicare PIN