Healthcare Provider Details

I. General information

NPI: 1407778657
Provider Name (Legal Business Name): ROMINA A DANA I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11065 41ST CT N
WEST PALM BEACH FL
33411-9106
US

IV. Provider business mailing address

11065 41ST CT N
WEST PALM BEACH FL
33411-9106
US

V. Phone/Fax

Practice location:
  • Phone: 386-868-9900
  • Fax:
Mailing address:
  • Phone: 386-868-9900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11048907
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: