Provider Demographics
NPI:1669982559
Name:ROUNDTREE, DEBORAH D
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:D
Last Name:ROUNDTREE
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 1:760 NW 33RD AVE
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33311-6527
Mailing Address - Country:US
Mailing Address - Phone:954-249-0440
Mailing Address - Fax:
Practice Address - Street 1:760 NW 33RD AVE
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33311-6527
Practice Address - Country:US
Practice Address - Phone:954-249-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCNA339173251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health