Provider Demographics
NPI:1275100786
Name:ROMERO MICULESCU, ANA MARIA
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:MARIA
Last Name:ROMERO MICULESCU
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 1:7014 BALBOA DR APT D
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32818-6574
Mailing Address - Country:US
Mailing Address - Phone:407-283-1308
Mailing Address - Fax:
Practice Address - Street 1:2144 MORRILTON CT
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32837-6779
Practice Address - Country:US
Practice Address - Phone:140-728-3130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-04
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1-21-50180103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst