Provider Demographics
NPI:1235837568
Name:ROYALTY THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:ROYALTY THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUSET
Authorized Official - Middle Name:THALIA
Authorized Official - Last Name:GONZALEZ DUQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-597-8543
Mailing Address - Street 1:6750 N ANDREWS AVE # 2021
Mailing Address - Street 2:
Mailing Address - City:FT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33309-2173
Mailing Address - Country:US
Mailing Address - Phone:786-597-8543
Mailing Address - Fax:
Practice Address - Street 1:6750 N ANDREWS AVE # 2021
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-2173
Practice Address - Country:US
Practice Address - Phone:786-597-8543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-16
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty