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General NPI Number Information
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NPI Number | 1649208257
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Entity Type | Individual
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Provider Name | YARITZA ROMAN MS, LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 06/30/2006
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Last Update Date | 12/09/2015
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Provider Practice Location Address
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Address Line | 6575 SW 88TH ST
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City | MIAMI
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State | FL
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Zip | 33156-1872
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Country | US
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Telephone | 305-666-7937
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Fax |
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Provider Business Mailing Address
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Address Line | 11343 SW 133RD PL
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City | MIAMI
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State | FL
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Zip | 33186-4332
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Country | US
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Telephone | 305-992-1151
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Fax | 786-709-4055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | AL1652
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License Number State | FL
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