Healthcare Provider Details

I. General information

NPI: 1194936757
Provider Name (Legal Business Name): CARLOS J ROMERO MARRERO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2007
Last Update Date: 02/05/2021
Certification Date: 02/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7369 SHERIDAN ST STE 300
HOLLYWOOD FL
33024-2776
US

IV. Provider business mailing address

7369 SHERIDAN ST STE 300
HOLLYWOOD FL
33024-2776
US

V. Phone/Fax

Practice location:
  • Phone: 954-451-5932
  • Fax:
Mailing address:
  • Phone: 954-451-5932
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number096715
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number104577
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number096715
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberME147148
License Number StateFL
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number15391
License Number StatePR
# 7
Primary TaxonomyN
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number52354
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: