Provider Demographics
NPI:1972371003
Name:ROMAN, YVETTE
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:
Last Name:ROMAN
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 1:3500 POSNER BLVD # 1372
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33837-3640
Mailing Address - Country:US
Mailing Address - Phone:407-863-6262
Mailing Address - Fax:407-815-7296
Practice Address - Street 1:9050 ALBA LN
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34747-1543
Practice Address - Country:US
Practice Address - Phone:407-863-6262
Practice Address - Fax:407-815-7296
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier