Provider Demographics
NPI:1447688791
Name:ROMAN-DUPUY, JOVANIE
Entity type:Individual
Prefix:
First Name:JOVANIE
Middle Name:
Last Name:ROMAN-DUPUY
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 1:17501 SW 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33177-2272
Mailing Address - Country:US
Mailing Address - Phone:305-254-9759
Mailing Address - Fax:
Practice Address - Street 1:17501 SW 117TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33177-2272
Practice Address - Country:US
Practice Address - Phone:305-254-9759
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health