Provider Demographics
NPI:1962076893
Name:DECEBAL, ROMANA
Entity type:Individual
Prefix:
First Name:ROMANA
Middle Name:
Last Name:DECEBAL
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 1:990 WOODBINE WAY APT 910
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33418-6558
Mailing Address - Country:US
Mailing Address - Phone:561-309-7440
Mailing Address - Fax:
Practice Address - Street 1:990 WOODBINE WAY APT 910
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33418-6558
Practice Address - Country:US
Practice Address - Phone:561-309-7440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-15
Last Update Date:2021-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA81090225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist