Healthcare Provider Details

I. General information

NPI: 1760447726
Provider Name (Legal Business Name): EZEQUIEL F. ROMERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 WEST 49TH STREET SUITE 604
HIALEAH FL
33012
US

IV. Provider business mailing address

1840 W 49TH ST STE 604
HIALEAH FL
33012-2887
US

V. Phone/Fax

Practice location:
  • Phone: 305-827-2100
  • Fax:
Mailing address:
  • Phone: 305-827-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME74480
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: