Healthcare Provider Details

I. General information

NPI: 1417586132
Provider Name (Legal Business Name): MARIA GABRIELA ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2020
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 W 42ND ST
HIALEAH FL
33012-4440
US

IV. Provider business mailing address

172 W 42ND ST
HIALEAH FL
33012-4440
US

V. Phone/Fax

Practice location:
  • Phone: 305-332-5528
  • Fax:
Mailing address:
  • Phone: 305-332-5528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME161841
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: