Provider Demographics
NPI:1568464253
Name:ROMEO, DONNA A (DC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:A
Last Name:ROMEO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-7602
Mailing Address - Country:US
Mailing Address - Phone:727-734-1901
Mailing Address - Fax:727-736-4000
Practice Address - Street 1:424 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-7602
Practice Address - Country:US
Practice Address - Phone:727-734-1901
Practice Address - Fax:727-736-4000
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH6730111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL3805778Medicaid
FLT21742Medicare UPIN
FL55147ZMedicare ID - Type Unspecified