Provider Demographics
NPI:1346207743
Name:ROMINE, PAUL M (DC)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:M
Last Name:ROMINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5325 US HIGHWAY 98 N
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33809-0518
Mailing Address - Country:US
Mailing Address - Phone:863-859-5441
Mailing Address - Fax:863-815-0684
Practice Address - Street 1:5325 US HIGHWAY 98 N
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33809-0518
Practice Address - Country:US
Practice Address - Phone:863-859-5441
Practice Address - Fax:863-815-0684
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2010-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL88591OtherBLUE CROSS BLUE SHIELD
FL0008776OtherGHI
FL407350522OtherRAILROAD MEDICARE
FLT55895Medicare UPIN
FL88591Medicare ID - Type Unspecified