Provider Demographics
NPI:1003029307
Name:MERYL B. ROME, MD, PA
Entity Type:Organization
Organization Name:MERYL B. ROME, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MERYL
Authorized Official - Middle Name:B
Authorized Official - Last Name:ROME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:954-391-2770
Mailing Address - Street 1:7100 W CAMINO REAL
Mailing Address - Street 2:STE. 207
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-5510
Mailing Address - Country:US
Mailing Address - Phone:561-391-2770
Mailing Address - Fax:561-391-2930
Practice Address - Street 1:7100 W CAMINO REAL
Practice Address - Street 2:STE. 207
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-5510
Practice Address - Country:US
Practice Address - Phone:561-391-2770
Practice Address - Fax:561-391-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME815652084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic MedicineGroup - Single Specialty