Provider Demographics
NPI:1184129744
Name:ROMITO, GIANINA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:GIANINA
Middle Name:
Last Name:ROMITO
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:64 W 55TH ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-4629
Mailing Address - Country:US
Mailing Address - Phone:412-720-6781
Mailing Address - Fax:
Practice Address - Street 1:GOV. CREEK HEALTH AND REHAB
Practice Address - Street 2:803 OAK STREET
Practice Address - City:GREEN COVE SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:32043
Practice Address - Country:US
Practice Address - Phone:904-284-5606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL16106235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist