MEDICARE: ROMA CHEERE RENIDO MATEO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MH24908	FL

General Provider Information

NPI Number	:	1023829561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROMA CHEERE RENIDO MATEO

Provider Business Mailing Address
First Line	:	1208 SPANISH STONE WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-1534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1208 SPANISH STONE WAY
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33415-1534
Country	:	US
Telephone Number	:	561-568-7397
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2025
Last Update Date	:	01/15/2025

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