Provider Demographics
NPI:1679914998
Name:ROMAN, RACHEL CELESTE
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:CELESTE
Last Name:ROMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 HILLCREST DR
Mailing Address - Street 2:UNIT 104
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-7977
Mailing Address - Country:US
Mailing Address - Phone:610-633-1173
Mailing Address - Fax:
Practice Address - Street 1:4301 N FEDERAL HIGHWAY SUITE 2 SOUTH
Practice Address - Street 2:BUTTERFLY EFFECTS LLC
Practice Address - City:POMPANO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064
Practice Address - Country:US
Practice Address - Phone:888-880-9270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2013-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist