Provider Demographics
NPI:1598896136
Name:DANGERVIL, ROMUALD (RRT)
Entity Type:Individual
Prefix:
First Name:ROMUALD
Middle Name:
Last Name:DANGERVIL
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:ROSE
Other - Last Name:JEANNOT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1630 NE 174TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33162-1439
Mailing Address - Country:US
Mailing Address - Phone:786-417-3957
Mailing Address - Fax:305-940-3829
Practice Address - Street 1:1630 NE 174TH ST
Practice Address - Street 2:
Practice Address - City:NORTH MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33162-1439
Practice Address - Country:US
Practice Address - Phone:786-417-3957
Practice Address - Fax:305-940-3829
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRT6258227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered