Provider Demographics
NPI:1265299325
Name:ROYAL, LATONYA
Entity type:Individual
Prefix:
First Name:LATONYA
Middle Name:
Last Name:ROYAL
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 1:562 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RIVIERA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33404-7402
Mailing Address - Country:US
Mailing Address - Phone:561-247-6220
Mailing Address - Fax:561-401-0249
Practice Address - Street 1:562 W 5TH ST
Practice Address - Street 2:
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33404-7402
Practice Address - Country:US
Practice Address - Phone:561-247-6220
Practice Address - Fax:561-401-0249
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility