Provider Demographics
NPI:1780785543
Name:ROMAN, MARIANNA (MOT, OTR/L)
Entity type:Individual
Prefix:MS
First Name:MARIANNA
Middle Name:
Last Name:ROMAN
Suffix:
Gender:F
Credentials:MOT, OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12355 PLEASANT GREEN WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-2052
Mailing Address - Country:US
Mailing Address - Phone:954-560-5639
Mailing Address - Fax:
Practice Address - Street 1:12355 PLEASANT GREEN WAY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-2052
Practice Address - Country:US
Practice Address - Phone:954-560-5639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT11725225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics