MEDICARE: JUAN C ROMERO P.A.

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	363A00000X	Physician Assistant	PA9101558	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1912943614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JUAN C ROMERO P.A.

Provider Business Mailing Address
First Line	:	8750 NW 36TH ST STE 300
Second Line	:
City	:	DORAL
State	:	FL
Zip	:	33178-2499
Country	:	US
Telephone Number	:	305-262-1610
Fax Number	:	305-907-6099

Provider Business Practice Location Address
First Line	:	4218 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33013-2306
Country	:	US
Telephone Number	:	305-266-2929
Fax Number	:	786-558-9980

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

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	11/22/2017

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Directions to “ JUAN C ROMERO P.A.” Practice Location

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