Provider Demographics
NPI:1215193628
Name:ROYAL, RONNETTE LASHAWN
Entity type:Individual
Prefix:MS
First Name:RONNETTE
Middle Name:LASHAWN
Last Name:ROYAL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 9TH ST NE
Mailing Address - Street 2:
Mailing Address - City:RUSKIN
Mailing Address - State:FL
Mailing Address - Zip Code:33570-7620
Mailing Address - Country:US
Mailing Address - Phone:813-645-8040
Mailing Address - Fax:813-645-5736
Practice Address - Street 1:510 9TH ST NE
Practice Address - Street 2:
Practice Address - City:RUSKIN
Practice Address - State:FL
Practice Address - Zip Code:33570-7620
Practice Address - Country:US
Practice Address - Phone:813-645-8040
Practice Address - Fax:813-645-5728
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL230630372600000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No372600000XNursing Service Related ProvidersAdult Companion