Provider Demographics
NPI:1669020996
Name:BEAS, ROMINA K
Entity Type:Individual
Prefix:
First Name:ROMINA
Middle Name:K
Last Name:BEAS
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 1:2115 CONWAY RD APT 1908
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32812-8959
Mailing Address - Country:US
Mailing Address - Phone:407-587-6430
Mailing Address - Fax:
Practice Address - Street 1:2115 CONWAY RD APT 1908
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32812-8959
Practice Address - Country:US
Practice Address - Phone:407-587-6430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider