Provider Demographics
NPI:1922392240
Name:ROME PSYCHIATRY
Entity Type:Organization
Organization Name:ROME PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:J
Authorized Official - Last Name:RADER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-675-4609
Mailing Address - Street 1:7301 W PALMETTO PARK RD
Mailing Address - Street 2:STE. 203A
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33433-3458
Mailing Address - Country:US
Mailing Address - Phone:561-391-2770
Mailing Address - Fax:561-391-2930
Practice Address - Street 1:7301 W PALMETTO PARK RD
Practice Address - Street 2:STE. 203A
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3458
Practice Address - Country:US
Practice Address - Phone:561-391-2770
Practice Address - Fax:561-391-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-03
Last Update Date:2011-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 815652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty