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General NPI Number Information
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NPI Number | 1063354413
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Entity Type | Organization
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Legal Business Name | ELITE DNA
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Dates
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Enumeration Date | 04/06/2026
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Last Update Date | 04/06/2026
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Provider Practice Location Address
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Address Line | 2913 LEE BLVD
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City | LEHIGH ACRES
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State | FL
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Zip | 33971-1438
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Country | US
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Telephone | 239-491-8204
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 SILVER GATE LN # D-410
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City | FORT MYERS
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State | FL
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Zip | 33907-1340
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Country | US
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Telephone | 239-841-5298
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Fax |
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Authorized Official
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Title or Position | UNLICENSED THERAPIST
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Name | XANAT ROMERO
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Credential | ROMERO
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Telephone | 239-841-5298
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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