Healthcare Provider Details

I. General information

NPI: 1720624612
Provider Name (Legal Business Name): ROMARIO FERREIRA DE SOUSA PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2019
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3275 SCIENCE PARK DR BLDG 5
BEACHWOOD OH
44122-7325
US

IV. Provider business mailing address

3275 SCIENCE PARK DR BLDG 5
BEACHWOOD OH
44122-7325
US

V. Phone/Fax

Practice location:
  • Phone: 216-448-6240
  • Fax: 216-448-4931
Mailing address:
  • Phone: 216-448-6240
  • Fax: 216-448-4931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberPT018962
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: