Provider Demographics
NPI:1891036521
Name:WILLIAM J. ROMANOS JR. M.D. P.A.
Entity Type:Organization
Organization Name:WILLIAM J. ROMANOS JR. M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:M
Authorized Official - Last Name:WALDRON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-221-0190
Mailing Address - Street 1:900 S US HIGHWAY 1
Mailing Address - Street 2:SUITE 101
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33477-6459
Mailing Address - Country:US
Mailing Address - Phone:561-746-7224
Mailing Address - Fax:561-743-3329
Practice Address - Street 1:900 S US HIGHWAY 1
Practice Address - Street 2:SUITE 101
Practice Address - City:JUPITER
Practice Address - State:FL
Practice Address - Zip Code:33477-6459
Practice Address - Country:US
Practice Address - Phone:561-746-7224
Practice Address - Fax:561-743-3329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-05
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL2084P0802X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Multi-Specialty
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL78167OtherBCBS
FL78167OtherBCBS