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General NPI Number Information
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NPI Number | 1841220159
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Entity Type | Individual
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Provider Name | HEATHER DEE ROMANO ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 01/24/2011
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Provider Practice Location Address
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Address Line | 1116 11TH ST SW
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City | LIVE OAK
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State | FL
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Zip | 32064-3608
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Country | US
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Telephone | 386-362-0820
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Fax | 386-362-0821
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Provider Business Mailing Address
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Address Line | 1116 11TH ST SW
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City | LIVE OAK
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State | FL
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Zip | 32064-3608
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Country | US
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Telephone | 386-362-0820
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Fax | 386-362-0821
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 352338-2111
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License Number State | FL
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