Provider Demographics
NPI:1053704718
Name:ROMA MEDICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:ROMA MEDICAL ASSOCIATES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ZECCARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:904-541-6144
Mailing Address - Street 1:7855 ARGYLE FOREST BLVD.
Mailing Address - Street 2:SUITE 905
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32244-7707
Mailing Address - Country:US
Mailing Address - Phone:904-541-6144
Mailing Address - Fax:904-541-6154
Practice Address - Street 1:7855 ARGYLE FOREST BLVD.
Practice Address - Street 2:SUITE 905
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32244-7707
Practice Address - Country:US
Practice Address - Phone:904-541-6144
Practice Address - Fax:904-541-6154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9832111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLDL623YMedicare PIN