Healthcare Provider Details

I. General information

NPI: 1578727053
Provider Name (Legal Business Name): ROMEO K. FERNANDEZ, M.D., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2008
Last Update Date: 04/07/2021
Certification Date: 04/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7000 W PALMETTO PARK RD STE 307
BOCA RATON FL
33433-3430
US

IV. Provider business mailing address

7000 W PALMETTO PARK RD STE 307
BOCA RATON FL
33433-3430
US

V. Phone/Fax

Practice location:
  • Phone: 561-288-5990
  • Fax: 954-391-5008
Mailing address:
  • Phone: 561-288-5990
  • Fax: 954-391-5008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberME 94928
License Number StateFL

VIII. Authorized Official

Name: DR. ROMEO K FERNANDEZ
Title or Position: PRESIDENT
Credential: MD
Phone: 561-288-5990