MEDICARE: MARITZA ROMERO APRN

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	207QA0505X	Adult Medicine Physician	AP135385	TX
2	363LG0600X	Gerontology Nurse Practitioner	AP135385	TX
3	363L00000X	Nurse Practitioner	AP135385	TX

General Provider Information

NPI Number	:	1356830889
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARITZA ROMERO APRN

Provider Business Mailing Address
First Line	:	3935 BANKS LANDING CT
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-4553
Country	:	US
Telephone Number	:	954-665-7258
Fax Number	:

Provider Business Practice Location Address
First Line	:	3935 BANKS LANDING CT
Second Line	:
City	:	FULSHEAR
State	:	TX
Zip	:	77441-4553
Country	:	US
Telephone Number	:	954-665-7258
Fax Number	:

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

Provider Enumeration Date	:	05/10/2018
Last Update Date	:	04/21/2024

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