Healthcare Provider Details

I. General information

NPI: 1962409235
Provider Name (Legal Business Name): PAOLO ROMERO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2005
Last Update Date: 04/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2121 E HARMONY RD UNIT 150
FORT COLLINS CO
80528-3413
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE SUITE 150
LOVELAND CO
80538-8702
US

V. Phone/Fax

Practice location:
  • Phone: 970-493-6337
  • Fax: 970-493-3528
Mailing address:
  • Phone: 970-624-4420
  • Fax: 970-624-4459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number38140
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number38140
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: