Healthcare Provider Details

I. General information

NPI: 1609563378
Provider Name (Legal Business Name): CAROLA ROMAY CSA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2023
Last Update Date: 04/21/2023
Certification Date: 04/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20900 BISCAYNE BLVD
AVENTURA FL
33180-1407
US

IV. Provider business mailing address

3 MARYLAND FARMS STE 200
BRENTWOOD TN
37027-5780
US

V. Phone/Fax

Practice location:
  • Phone: 305-682-7000
  • Fax:
Mailing address:
  • Phone: 800-348-4565
  • Fax: 888-203-4247

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number22-498
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: