Provider Demographics
NPI:1689169112
Name:DAMORE, ROMINA NATALIA (RBT)
Entity Type:Individual
Prefix:MISS
First Name:ROMINA
Middle Name:NATALIA
Last Name:DAMORE
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3674 SW 26TH ST # 4
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-2011
Mailing Address - Country:US
Mailing Address - Phone:305-793-0127
Mailing Address - Fax:
Practice Address - Street 1:3674 SW 26TH ST # 4
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33133-2011
Practice Address - Country:US
Practice Address - Phone:305-793-0127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-27
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL18-58072106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician