MEDICARE: DR. REY R ROMERO M.D

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	2084N0400X	Neurology Physician	MD12702	HI

General Provider Information

NPI Number	:	1265487334
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REY R ROMERO M.D

Provider Business Mailing Address
First Line	:	91-2139 FT WEAVER RD
Second Line	:	SUITE 300
City	:	EWA BEACH
State	:	HI
Zip	:	96706
Country	:	US
Telephone Number	:	808-680-0558
Fax Number	:	808-680-0500

Provider Business Practice Location Address
First Line	:	91-2139 FORT WEAVER RD
Second Line	:	SUITE 300
City	:	EWA BEACH
State	:	HI
Zip	:	96706-3607
Country	:	US
Telephone Number	:	808-680-0558
Fax Number	:	808-680-0500

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	07/08/2007

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