MEDICARE: CASIMIRO ROMO BSW

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	104100000X	Social Worker		NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538241880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASIMIRO ROMO BSW

Provider Business Mailing Address
First Line	:	3001 HOT SPRINGS BLVD
Second Line	:	SUITE #5
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4175
Country	:	US
Telephone Number	:	505-425-6786
Fax Number	:	505-425-6787

Provider Business Practice Location Address
First Line	:	3001 HOT SPRINGS BLVD
Second Line	:	SUITE #5
City	:	LAS VEGAS
State	:	NM
Zip	:	87701-4175
Country	:	US
Telephone Number	:	505-425-6786
Fax Number	:	505-425-6787

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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Directions to “ CASIMIRO ROMO BSW” Practice Location

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