Provider Demographics
NPI:1225893423
Name:ROMEO, JAMILA AISHA
Entity Type:Individual
Prefix:
First Name:JAMILA
Middle Name:AISHA
Last Name:ROMEO
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 1:3469 W BOYNTON BEACH BLVD STE 2 PMB #
Mailing Address - Street 2:STE 2 PMB #
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33436
Mailing Address - Country:US
Mailing Address - Phone:561-884-8474
Mailing Address - Fax:
Practice Address - Street 1:1406 W BOYNTON BEACH BLVD
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33426-3412
Practice Address - Country:US
Practice Address - Phone:561-884-4847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier