Provider Demographics
NPI:1639797772
Name:ROMEO'S SENSATION LLC
Entity Type:Organization
Organization Name:ROMEO'S SENSATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROMEL
Authorized Official - Middle Name:POWELL
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-891-9061
Mailing Address - Street 1:PO BOX 263244
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33685-3244
Mailing Address - Country:US
Mailing Address - Phone:813-461-3098
Mailing Address - Fax:813-475-4431
Practice Address - Street 1:531 VERSAILLES DR
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-7317
Practice Address - Country:US
Practice Address - Phone:813-461-3098
Practice Address - Fax:813-475-4431
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-06
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL107335900Medicaid