Healthcare Provider Details

I. General information

NPI: 1952418626
Provider Name (Legal Business Name): ROMEO K FERNANDEZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
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 TaxonomyN
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number26151
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberME95928
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: